酶联免疫斑点法检测甲型H1N1流感患者Th1／Th2细胞的变化

Change of Th1/Th2 lymphocyte subsets in patients with influenza A（H1N1） infection and its significance

目的通过酶联免疫斑点法（ELISPOT）检测，探讨甲型H1N1流感患者TH1／Th2细胞的变化及其临床意义。方法对40例H1N1患者、42例流感样患者及45例健康体检者采用ELISPOT技术检测TH1／Th2细胞，同时进行外周血中的白细胞、淋巴细胞及其亚群计数。结果H1N1患者的白细胞、淋巴细胞、T细胞计数（包括T4、T8）与流感样患者及健康体检者比较明显偏低（P〈0．05）；B细胞计数与健康体检者比较明显偏低（P〈0．05）；而H1N1患者NK细胞与流感样患者、健康体检者比较．差异均无统计学意义（均P〉0．05）。H1N1组、流感样组和健康对照组中IFN-y特异的ELISPOT检测SFC数量M值分别为23、365、43，H1N1组与流感样组、健康对照组比较，差异均有统计学意义（均P〈0．05）。H1N1组、流感样组和健康组中IL-4特异的ELtSPOT检测SFC数量M值分别为365、27、23，H1N1组与健康对照组比较，差异有统计学意义（Jp〈0．05）；但与流感样组比较，差异无统计学意义（P〉0．05）。结论H1N1感染可引起机体淋巴细胞及其亚群的数量发生异常改变，引起患者机体免疫系统的紊乱。通过ELISPOT技术可从单细胞水平明确CD4^＋叮淋巴细胞亚群中的Th1和Th2细胞的异常改变。

Objective To investigate the change of Th1/Th2 lymphocyte subsets in patients with influenza A （H1N1） infection and its clinical significance. Methods Lymphocyte subsets were analyzed by enzyme-linked immunospot （ELISPOT） assay in 40 patients with influenza A（H1N1） infection, 42 influenza-like patients and 45 healthy subjects. Results White blood cell, lym- phocyte and T cell including T4 and T8 in H1N1 patients were significantly lower than those in influenza patients and healthy con- trols （P〈0.05）. B cell in H1N1 patients was also significantly lower than that in control subjects （P〈0.05）. There were no signifi-cance differences in NK cells among three groups（P 〉0.05）. Median value of IFN-,/ specific spot forming cells （SFC） in H,N1 patients, influenza-like patients and healthy controls were 23, 36.5 and 43 respectively（P〈0.05 ）.Median value of IL-4 specific spot forming cells （SFC） in H1N1 patients was higher than that in controls （36.5 vs 23, P〈0.05）, but there was no difference be- tween H1N1 patients and influenza-like patients（36.5 vs 27, P 〉0.05）. Conclusion H1N1 virus infection is associated with abnormality of lymphocyte amount and its subsets, which can be detected by ELISPOT technology at a single cell level.