麻疹患者肝功能和淋巴细胞亚群检测及其意义

Comparison of liver function and T-cell subgroups between adult and infant measles patients

目的研究成人及幼儿麻疹患者肝功能和淋巴细胞变化特点差异及其临床意义。方法检测32例成人及26例幼儿麻疹患者肝功能及外周血CD3+、CD4+、CD8+、CD19+淋巴细胞,并与40例正常健康对照组比较。结果成人麻疹组丙氨酸氨基转移酶(ALT)异常率为71.9%(23/32),幼儿麻疹组患者未出现ALT升高,两组差异有统计学意义。成人麻疹组天冬氨酸氨基转移酶(AST)和ALT水平以及CD3+、CD4+、CD8+、CD19+淋巴细胞比例分别为:115(12～644)IU/L、74(18～395)IU/L、(60.31±13.17)%、(40.08±10.62)%、(48.79±10.20)%及(19.30±9.60)%。幼儿组分别为:25(14～37)IU/L、50(34～68)IU/L、(64.73±12.58)%、(30.14±12.45)%、(30.45±9.11)%及(20.72±11.39)%。两组麻疹组与对照组比较,成人组ALT及AST均明显高于幼儿组,CD4+T细胞比例下降、CD8+T细胞比例升高,成人麻疹组CD19+B细胞比例升高,与对照组比较差异有统计学意义(P<0.05)。结论麻疹患者T、B淋巴系统均受到麻疹病毒损伤,然成人与幼儿免疫系统发育程度不同,致损害程度略有差异,表现为成人麻疹患者肝功能损害大于幼儿组,而幼儿麻疹组感染病程延长、并发症多,病情重、病死增高,故加强上述检测有助于临床病情判断及治疗方案选择。

Objective To study and compare the hepatic function and lymphocyte subsets in adult and infant pa- tients infected by measles virus and its clinical signifiance. Methods Thirty-two adult, 26 infant measles pa- tients and 40 healthy controls were included in the study, and hepatic function and CD3＋ , CD4＋ , CD8＋ , CD19＋ lymphocyte subsets in the peripheral blood were detected. Results Alanine aminotransferase （ALT） was elevated in 71.9% of the adult measles patients while normal ALT levels were detected in all infant mea sles patients （P〈0.05）. The levels of aspartate aminotransferase （AST）, ALT and the CD3＋, CD4＋, CD8＋ , CD19＋ counts in adult measles patients were 115 （12-644） IU/L, 74 （18-395） IU/L and （60.31±13.17）%, （40.08±10.62）%, （48. 79 ±10. 20）% , （19.30!9.60）%, respectively; whereas in infant measles patients the results are 25 （14-37） IU/L and, 50 （34-68） IU/L, （64.73±12.58）%, （30. 14± 12.45）%, （30.45±9.11）%, （20.72±11.39）%, respectively. Comparing to the results from the respective control group, the ALT and AST levels, the CD4＋ and CD19＋ counts in the adult measles group were signifi- cantly higher while the CD8＋ count was significantly lower than that in the infant group. Conclusions T and B lymphatic systems were damaged in both adult and infant measles patients. The liver function in adult measles patients was impaired more severely than that in the infant group, while infant patients often suffer longer course and more complications accounting for a higher death rate.