川崎病患儿外周血淋巴细胞亚群的变化及临床诊断意义

Changes and clinical significance of diagnosis of peripheral blood lymphocyte subsets on children kawasaki disease

目的探究川崎病患儿外周血淋巴细胞亚群的变化情况及其临床诊断价值。方法选取我院2012年6月至2014年9月收治的25例川崎病患儿为实验组,另选取同期来我院体查的15例健康体检儿童为对照组,采用流式细胞术,对两组儿童外周血淋巴细胞亚群(CD3+、CD3+CD8+、CD3+CD4+、CD3-CD16+CD56+、CD19+CD23+、CD3-CD19+、CD4+CD25+、CD4+/CD8+)进行检测,观察两组检测结果。结果实验组CD4+/CD8+、CD3+CD4+、CD19+CD23+、CD3-CD19+明显高于对照组,CD3+CD8+、CD3+、CD4+CD25+呈下降趋势,差异有统计学意义(P<0.05);CD3+、CD3+CD8+、CD3+CD4+、CD19+CD23+、CD3-CD19+、CD4+CD25+、CD4+/CD8+的ROC曲线下面积依次为76.0%、80.5%、72.4%、73.6%、79.6%、72.7%、73.6%。结论儿童川崎病急性期往往伴有免疫紊乱及免疫活化情况,可将CD4+/CD8+、CD3-CD19+、CD3+CD8+、CD3+CD4+的诊断界值作为川崎病的早期诊断指标,值得临床积极借鉴。

Objective To explore the value of changes of peripheral blood lymphocyte subsets in children with Kawasaki disease and clinical diagnosis. Methods 25 ceses of Kawasaki disease patients admitted in our hospital from June 2012 to September 2014 as the experimental group,the other 15 cases of healthy children were selected in our hospital who did physical examination during the same period as the control group,using flow cytometry,detected two groups of peripheral blood lymphocyte subsets（ CD3^＋、CD3^＋CD8^＋、CD3^＋CD4^＋、CD3^-CD16^＋CD56^＋、CD19^＋CD23＋、CD3^-CD19^＋、CD4^＋CD25^＋、CD4^＋/ CD8^＋）,were observed the detection result in the two groups. Results In experimental group CD4^＋/ CD8^＋（ % ： 2. 1 ± 0. 7 vs 1. 6 ± 0. 5）,CD3^＋CD4^＋（ % ： 34. 8 ± 8. 1 vs 18. 9 ± 4. 8）,CD19^＋CD23＋（ % ： 15. 2 ± 6. 1 vs 10. 6 ± 4. 7）,CD3^-CD19^＋（ % ： 34. 9 ±12. 8 vs 22. 9 ± 6. 9） were significantly higher than the control group,CD3^＋CD8^＋（ % ： 6. 9 ± 4. 9 vs 23. 0 ±5. 2）,CD3^＋（ % ： 55. 1 ± 11. 1 vs 64. 8 ± 5. 7）,CD4^＋CD25^＋（ % ： 4. 8 ± 1. 1 vs 6. 2 ± 1. 7） decreased,the differences were statistically significant（ P〈0. 05）; ROC curve area of CD3^＋,CD3^＋CD8^＋,CD3^＋CD4^＋,CD19^＋CD23＋,CD3^-CD19^＋,CD4^＋CD25^＋,CD4^＋/ CD8^＋were 76%,80. 5%,72. 4%,73. 6%,79. 6%,72. 7%,73. 6%. Conclusions Children Kawasaki disease often associated with immune disorders and immune activation,the value of CD4^＋/ CD8^＋,CD3^-CD19^＋,CD3^＋CD8^＋,CD3^＋CD4^＋can be used as an early diagnostic indexes of Kawasaki disease,is worthy of clinical reference actively.