儿童抽动障碍与微小病毒B_(19)感染和免疫功能

Human Parvovirus B_ 19 and Immune Function in Children with Tic Disorder

目的:探讨抽动障碍(TD)与人微小病毒B19(HPV-B19)、巨细胞病毒(CMV)、A型链球菌感染和免疫功能的关系及其临床意义。方法:采用酶联免疫吸附法测定60例TD患儿血清HPV-B19-IgM,CMV-IgM,采用凝集反应测定抗链球菌溶血素“O”抗体滴度(ASO),并行血常规、免疫功能检查。对照组为20例正常儿童。结果:60例TD患儿中有14例(23·3%)HPV-B19-IgM阳性,而健康儿童均为阴性(χ2=5·67,P<0·05)。两组儿童CMV-IgM阳性率、ASO滴度及外周血血红蛋白、白细胞计数和血小板数及体液免疫(IgA、IgG、IgM)比较差异无统计学显著性。细胞免疫功能检测CD4+细胞百分比、CD4+/CD8+细胞比值及NK阳性细胞百分比HPV-B19-IgM阳性组(25·76±10·21%,0·78±0·42,8·77±5·64%)与HPV-B19-IgM阴性组(26·89±9·08%,0·88±0·35,9·61±6·45%)均较对照组(38·31±6·95%,1·58±0·29,14·83±4·16%)明显降低,而CD8+细胞百分比(HPV-B19-IgM阳性组为32·98±10·3%,HPV-B19-IgM阴性组为32·58±9·04%)较对照组(24·82±5·54%)明显升高(P<0·01)。结论:抽动障碍患儿HPV-B19感染率较高。细胞免疫功能紊乱可能是各种原因导致儿童TD发生的一个共同途径。

Objective： To explore the situation of human parvovirus B19 （ HPV-B19 ） , cytomegalovirus （CMV） , Group A hemolytic streptococcal infections and immune function in children with tic disorders （ TD ） . Methods： Sixty children with TD were involved in the study. HPV-B19-IgM and CMV-IgM were examined using ELISA method. The titers of antistreptolysin O （ ASO ） was examined by agglutination. We also detected immune function, the ferrohemoglobin level, leucocyte count and platelet count of peripheral smear in the study. There were 20 healthy children as control group. Results： The positive rate of HPV-B19-IgM （23.3%） were significantly higher than that of control （all are negative, x^2 = 5. 67, P 〈 0. 05 ） . There was no difference of the positive rate of CMV-IgM, the titers of ASO, the peripheral smear and the levels of IgA, IgG, IgM between the two groups. The levels of CD4 ^＋ , CD4^＋/ CD8^＋ and NKC in TD were significantly depressed, compared to that in healthy controls （ 38.31 ± 6. 95%, 1.58 ± 0. 29, 14. 83±4. 16% ）, but there was no significantly different between HPV-B19-IgM positive group （25. 76 ± 10. 21%, 0. 78 ± 0.42, 8.77 ± 5.64% ） and HPV-B1g-IgM negative group （ 26. 89 ± 9. 08%, 0. 88 ± 0. 35, 9. 61 ± 6. 45% ） . Conclusions. The present study demonstrates that the HPV-B19 infection is more common in children with TD. The low cell immune functional state may be a common pathway resulting in TD.