儿童感染肺炎支原体后细胞免疫状态的变化及临床意义

Changes and clinical significance of cytological immune function in children infected with mycoplasma pneumoniae

目的:探讨儿童感染支原体肺炎后细胞免疫功能的变化及临床意义。方法:分别采用流式细胞术和细胞酶免疫分析法,对38例肺炎支原体感染患儿的T淋巴细胞亚群(CD3+、CD4+、CD8+CD28+、CD8+CD28-)的表达和红细胞补体受体1(CR1,即CD35)进行分子定量检测,45例普通肺炎患儿作为对照组检测上述指标。结果:支原体肺炎组患儿急性期红细胞CRl表达明显下降,CD3+、CD4+、CD8+CD28+表达减少,而CD8+CD28-表达升高,与对照组比较有显著性差异(P<0.01)。在恢复期上述情况有所改善,但与对照组相比仍有显著性差异(P<0.05),相关分析表明红细胞CR1与CD8+CD28-呈负相关(R=-0.512,P<0.05)。结论:支原体肺炎儿童存在红细胞免疫功能低下及T淋巴细胞活化异常,其中CD8+CD28-细胞群的活化障碍和红细胞免疫功能的持续异常,可能是发生继发性过敏性咳嗽的重要细胞免疫学基础。

Objective： To study the changes and clinical significance of cytological immune function in children suffered from mycoplasma pneumonia （MP） . Methods： 38 cases of MP and 45 cases of common pneumonia were included. T lymphocytes subsets, including CD3 ＋ , CD4 ＋ , CD8 ＋ CD28 ＋ , CD8 ＋ CD28 - expression on the peripheral blood mononuclear cells were determined with flow cytometry. The number of erythrocyte CPd （ ECR1 ） was quantitatively assayed through alkaline phosphatase conjugated to the first and second antibodies. Results： The expression of ECR1 and CD3 ＋ , CIM ＋, CD8 ＋ CD28 ＋ in MP individuals was obviously lower than those in control group during acute phase, while that of CD8 ＋ CD28 - was higher in MP group than those in control group （ P 〈 0. 01 ）. The difference was decreased during the recovering phase with stastical significancc （ P 〈 0. 05 ）. Relative analysis showed there was negative relativity between ECR1 and CD8 ＋ CD28 -. Conclusion： There is disturbance of immune function in children wilh MP, which focus on the depression of RBC immune fimction and T lymphocyte inactivation. The inactivation of T - lymphocyte subset CD8 ＋ CD28 - and consistent decreased expression of ECR1 are probably the main causes of subsequent allergic cough, at the extent of cytological immunology.