肺炎支原体肺炎患儿支气管肺泡灌洗液T淋巴细胞亚群分析

Analysis on T lymphocyte subgroups of bronchoalveolar lavage fluid in children with Mycoplasma pneumoniae pneumonia

目的探讨肺炎支原体肺炎(MPP)患儿支气管肺泡灌洗液(BALF)中T细胞亚群分布,研究MPP的免疫损伤机制,为MPP免疫学治疗的可能性提供实验依据。方法收集2012年1月1日-12月31日湖南省人民医院儿科医学中心收治的MPP患儿共78例分别于急性期和恢复期经纤维支气管镜采集BALF样本,收集同期因支气管异物、支气管发育畸形以及慢性咳嗽入住本院儿科医学中心患儿BALF样本61例,采用流式细胞技术检测BALF中T淋巴细胞亚群。结果MPP患者急性期和恢复期CD3+T细胞与对照组比较差异无统计学意义(P>0.05),而CD4+和CD4+/CD8+检测结果MPP急性期和MPP恢复期均要低于对照组(P<0.01),CD8+检测结果 MPP急性期和恢复期高于对照组(P<0.01)。结论 MPP患儿存在细胞免疫失调,本研究进一步为临床应用免疫调节剂治疗MPP提供了理论依据。

Objective To explore the distribution of T-cell subsets in bronchoalveolar lavage fluid（ BALF） samples of children with Mycoplasma pneumoniae pneumonia（ MPP）,to study the immune injury mechanism of MPP,and to provide experimental evidence for the possibility of MPP immunological therapy. Methods Seventy-eight children with MPP hospitalized in Pediatric Medical Center,the People＇s Hospital of Hunan Province during January 1,2012 through December31,2012 were enrolled in this study. We collected BALF samples via fiberoptic bronchoscopy during the acute phase of illness and during convalescence. At the same time,61 BALF samples were collected from children with bronchial foreign body,with bronchial malformations and with chronic cough in the above-mentioned center of the hospital. Flow cytometry was used to detect T lymphocyte subsets in all BALF samples. Results No statistically significant difference was found in the CD3＋T-cell count between control group and MPP children during the acute phase and during convalescence（ P〉0.05）. The testing results showed that the CD4＋T-cell count and the CD4＋/CD8＋T lymphocytes ratio were lower in MPP children during the acute phase and during convalescence than in the control group（ P〈0. 01）,but the CD8＋T-cell count was higher in MPP children during the acute phase and during convalescence than in the control group（ P〈0. 01）. Conclusions The results suggest that children with MPP show cellular immune imbalance. This study further provides a theoretical basis for clinical application of immune modulators in treating MPP.