EB病毒感染儿童免疫功能状况及其与临床和预后的关系研究

Study on immunity function and its relationship with clinic and prognosis in children infected by Epstein-Barr virus

目的探讨EB病毒感染所致的传染性单核细胞增多症（IM）患儿免疫功能状况及其与临床和预后的关系。方法用免疫放射比浊法检测50例IM患儿（IM组）急性期、恢复期血清免疫球蛋白，用流式细胞术检测外周血T淋巴细胞亚群CD3＋、CD4＋、CD8＋、CD19＋、CD23＋，同期检测50例同龄健康儿童（对照组）。结果IM组急性期IgA、IsG、IgM分别为（0.75±0．65）、（7．55±2．05）、（1．85±0．55）g／L，IM组恢复期分别为（0．95±0．55）、（8．85±2．25）、（1．75±0．65）g/L，对照组分别为（1．25±0．75）、（10．65±2．55）、（1．80±0．50）g／L，IM组急性期IgA、IgG明显低于IM组恢复期和对照组（P〈O．01），而IgM与IM组恢复期和对照组比较差异无统计学意义（P〉0．05）。IM组急性期CD3＋、CD4＋、CD8＋,CD4＋／CD8＋、CD19＋、CD23＋分别为0．6050±0．0850、0．2080±0．0315、0．6520±0．0520、0．45±0．35、0．0580±0．0205、0．0250±0．0135，IM组恢复期分别为0．7220±0．0820、0．3575．±0．0375、0．3565±0．0565、1．45±0．45、0．1580±0．0280、0．0625±0．0225，对照组分别为0．7530±0．0830、0．4850±0．0450、0．3275±0．0575、1．48±0．55、0．1850±0．0560、0．0805±0．0175，IM组急性期CD3＋,CD4＋、CD4＋／CD8＋、CD19＋、CD23＋明显低于IM组恢复期和对照组（P〈0．05），而CD8＋明显高于IM组恢复期和对照组（P〈0．05）。结论EB病毒感染患儿外周血免疫球蛋白、T淋巴细胞亚群明显异常。

Objective To study on immunity function in infectious mononucleosis （IM） children infected by Epstein-Barr virus （EBV） and its relationship with clinic and prognosis. Methods Serum immunoglobulin was detected by immunoradiometric nephelometry, expressions of CD3＋, CD4＋, CD8＋, CD19＋, CD23＋ on T-lymphocytes subset in peripheral blood were measured by flow cytometry in 50 IM （IM group） who was in acute and convalescent period, and compared with 50 healthy controls （control group）. Results The levels of IgA, IgG, IgM in IM group with acute period were （0.75 ± 0.65 ）, （7.55 ± 2.05）, （ 1.85 ± 0.55 ） g/L, in IM group with convalescent period were （0.95 ± 0.55）, （8.85 ± 2.25 ）, （ 1.75 ± 0.65） g/L. In control group,those were （1.25 ± 0.75）, （10.65 ±2.55）, （1.80 ±0.50） g/L. IgA and IgG in IM group with acute period were significantly lower than those in IM group with convalescent period and control group （P 〈 0.01）,but IgM was no significant difference among them （P 〉0.05 ）. The levels of CD3＋,CD4＋,CD8＋, CD4＋/CD8＋, C D19＋, CD23＋ in IM group with acute period were 0.6050 ± 0.0850,0.2080 ± 0.0315,0.6520± 0.0520, 0.45 ± 0.35,0.0580 ± 0.0205,0.0250 ± 0.0135,in IM group with convalescent period were 0.7220 ± 0.0820, 0.3575 ± 0.0375,0.3565 ± 0.0565,1.45 ± 0.45,0.1580 ± 0.0280,0.0625 ± 0.0225. In control group, those were 0.7530 ± 0.0830,0.4850 ± 0.0450,0.3275 ± 0.0575,1.48 ± 0.55,0.1850 ± 0.0560,0.0805 ± 0.0175. CD3＋, CD4＋, CD4＋/CD8＋, CD19＋, CD23＋ in IM group with acute period were significantly lower than those in IM group with convalescent period and eontrol group （P 〈 0.05 ） ,but CD8± was significantly higher than that in IM group with convalescent period and eontrol group （P 〈0.05）. Conclusion The abnormality of immunoglobulin and T-lymphoeytes subset in children infeeted by EBV is obvious.