CD4^+T细胞亚群及细胞因子在儿童肺炎及哮喘中的临床意义

Clinical significance of CD4^+ T subset and cytokine in children with pneumonia or asthma

目的测定哮喘与肺炎患儿外周血CD4+T细胞内Th1、Th2、Th17和CD4+CD25+FOXP3调节性T细胞的水平,分析这些指标在儿科临床的实用价值。方法收集2011年9月～2012年1月哮喘急性发作期患儿14例、肺炎患儿17例,另外选择14例健康儿童为对照组。采用流式细胞技术,测定其外周血CD4+T细胞内细胞因子Th1、Th2、Th17及外周血中CD4+CD25+FOXP3调节性T细胞的水平,观察分析各个检测因子变化情况。结果哮喘患儿Th2、Th17与对照组比较均有统计学差异(P<0.05),且与血常规中淋巴细胞百分比及嗜酸性粒细胞百分比有明显相关性(P<0.05或P<0.01);肺炎患儿CD4+CD25+FOXP3调节性T细胞与对照组差异有统计学意义(P<0.05),与血常规中单核细胞百分比有明显相关性(P<0.05);哮喘组Th2、Th17、CD4+CD25+调节性T细胞水平较肺炎组有显著升高(P<0.05)。结论流式细胞仪检测CD4+T淋巴细胞内细胞因子(Th1/Th2/Th17)和CD4+CD25+调节性T细胞可作为判断哮喘及肺炎患儿免疫反应的检测指标,对诊断、治疗及疗效观察有一定的临床意义。

Objective To detect the levels of cytokine（Th1,Th2 and Th17）and regulatory T cell（CD4＋CD25＋ FOXP3）within the CD4＋ T cell in peripheral blood of children with pneumonia or asthma,and to analyze the clinical practical value of these indexes in the department of pediatrics.Methods The medical data were collected among 14 children with asthma and 17 ones with pneumonia all in the acute period of onset in September,2011 to January,2012.Another 14 health ones were chosen as the control group.The levels of cytokine（Th1,Th2 and Th17）within the CD4＋ T cell and CD4＋CD25＋ FOXP3 regulatory T cell in the peripheral blood were detected by flow cytometry,and observation was made in the changes of these factors.Results There were significant differences in the levels of Th2 and Th17 between asthmatic children and those health children（P0.05）.And the levels of Th2 and Th17 had obvious correlation with the percentages of lymphocyte and eosinophilic granulocyte in the routine blood test（P0.05 or P0.01）.There were significant differences in the level of CD4＋CD25＋ regulatory T cell between pneumonia children and those health ones（P0.05）,and the level had a correlation with the percentage of monocyte in the routine blood test（P0.05）.The levels of Th2,Th17 and CD4＋CD25＋ regulatory T cell in the group with asthma increased significantly compared with those in the group with pneumonia（P0.05）.Conclusion The cytokine（Th1/Th2/Th17）in CD4＋ T lymphocyte and CD4＋CD25＋ regulatory T cell detected by flow cytometry can be considered as detection indicators judging the immune reaction of children with asthma or pneumonia,which have clinical significance in the diagnosis,treatment and observation of clinical effects.