儿童传染性单核细胞增多症淋巴细胞亚群的变化及意义

Variation and significance of lymphocte subsets in infectious mononucleosis in children

目的通过对儿童传染性单核细胞增多症(infectious mononucleosis,IM)外周血淋巴细胞亚群的检测,探讨其细胞免疫功能变化与疾病的关系。方法采用流式细胞仪对35例IM患儿外周血T、B和NK淋巴细胞亚群进行检测,30例健康儿童作为对照组;对患儿中的7例进行治疗2周后细胞亚群的测定以观察动态变化;对患儿进行外周血异型淋巴细胞计数。结果 IM患儿CD3、CD8 T淋巴细胞水平明显升高,CD19、NK、CD4和CD4/CD8值水平明显降低,分别与正常对照组比较差异均有统计学意义。7例IM患儿治疗2周后T细胞亚群的测定值与入院时比较差异有统计学意义,治疗前CD4、CD4/CD8值低于治疗后,治疗前CD8高于治疗后。IM患儿急性期CD8、CD4/CD8水平与患儿外周血异型淋巴细胞百分率(≤10%和>10%)的差异有统计学意义。结论检测淋巴细胞亚群对评估IM患儿的细胞免疫状况,辅助诊断和指导治疗具有重要的临床价值。

Objective To measure the expression level of lymphocyte subsets in peripheral blood in order to investigate the change of immunity in children with infectious mononucleosis （IM）. Method T, B and NK lymphoetyte subsets in peripheral blood of 35 cases with IM were measured by flow cytometry and compared with 30 normal children. We measured the expression level of lymphocyte subsets of 7 cases two weeks after treatment in order to explore the dynamic changes. Additional- ly, atypical lymphocyte were counted in peripheral blood of IM children. Result Compared with normal children, the levels of CD3 and CD8 cells were significantly higher, while the levels of CD4, CD19, NK cells and the ratio of CD4/CD8 were significantly lower in 35 children with IM. The level of lymphocyte subsets of the 7 cases of IM had difference, after two weeks treat- ment, from that at the time of admitting. The levels of CD8 cells before treatment were higher, and the levels of CD4 and the ratio of CD4/CD8 were lower than those after treatment. The levels of CD8 cells and the ratios of CD4/CD8 had difference between ≤10% and 〉 10% of the percentage of atypical lymphocytes. Conclusion The lymphocyte subtypes in peripheral blood of IM children is significant to evaluate the cellular immune function of IM children, and helpful to the clinical diagnosis and therapy.