反复呼吸道感染患儿树突状细胞水平和免疫功能的研究

Study of dendritic cell levels and the immune function in children with recurrent respiratory tract infection

目的检测反复呼吸道感染(RRI)患儿树突状细胞(DC)水平及与树突状细胞活性密切相关的细胞免疫及体液免疫功能指标的变化,并探讨其临床指导意义。方法分别检测53例反复呼吸道感染患儿外周血CD3、CD4、CD8、CD4/CD8淋巴细胞亚群及免疫球蛋白IgG、IgA、IgM的含量变化,其中42例测DC水平,并与具有可比性的36例健康儿童进行对照研究。结果病例组外周血DC水平[(5.21±1.74)×106/L)]显著低于对照组,两组比较差异具有统计学意义(P<0.05);CD3、CD4、CD4/CD8与对照组比较均明显下降(P<0.05);CD8无显著性变化;免疫球蛋白IgG、IgA含量显著性下降(P<0.01),IgM无显著性变化。结论 RRI患儿存在DC活性下降和免疫功能失调,细胞免疫和体液免疫功能均有不同程度的下降,并可能与患儿的发病、病情转归、预后等有关,这些指标的变化可作为评价疗效的参考指标。DC计数及活性分析可作为RRI研究的一个新视角。

Objective To detect the levels of dendritic cell （DC）, analyze the changes of immune function in children with recurrent respiratory tract infection （RRI）, and discuss the association and the clinical significance between them. Methods T-lymphocyte subset CD3 , CD4 , CD8 , CD4 /CD8 and indexes of IgG, IgA, IgM were detected in 53 children with RRI （RRI group）, with levels of DC tested in the peripheral blood of 42 patients by flow cytometry, which were then compared with those of 36 healthy children （the control group）. Results In RRI group, the levels of DC in peripheral blood were （5.21±1.74）×10 6 /L, significantly lower than those of the control group （P0.05）. The levels of CD3 , CD4 , CD4 /CD8 ratio as well as IgG, IgA in RRI group were significantly lower than those of the control group （P0.01）, while the levels of CD8 and IgM showed no statistical significant difference between the two groups. Conclusion There are abnormal changes in the cell immunity and body fluid immunity function. The children with RRI have lower levels of DC and decreased immune function. The contents of DC, T lymphocyte subset and immuno-globulin may be regarded as important indicators of disease severity and associated with the therapeutic effects.