病毒性脑炎患儿脑脊液中淋巴细胞亚群含量评估及其与病情相关性的研究

Study on assessment of lymphocyte subset contents in cerebrospinal fluid of children with viral encephalitis and their correlation with disease

目的：研究病毒性脑炎患儿脑脊液中淋巴细胞亚群的含量及其与病情的相关性。方法：选择病毒性脑炎患儿作为脑病组,选择经腰穿排除中枢神经系统感染的患儿或无中枢神经系统疾病而需腰麻行外科手术的患儿作为对照组,采集脑脊液和血清,测定淋巴细胞亚群含量、神经损伤分子含量以及炎症反应指标、氧化应激反应指标。结果：脑病组脑脊液中CD3^＋、CD3^＋CD4^＋、CD4/CD8、CD16^＋CD56^＋均低于对照组,CD3^＋CD8＋、CD19^＋均高于对照组（P〈0.05）;MRI异常患儿脑脊液中CD3^＋、CD3^＋CD4^＋、CD4/CD8、CD16^＋CD56＋均低于MRI正常组,CD3^＋CD8^＋、CD19^＋均高于MRI正常组（P〈0.05）;脑病组脑脊液和血清中NSE、MBP、S-100、NPT的含量明显高于对照组且与淋巴细胞亚群含量具有良好的相关性（P〈0.05）;脑病组脑脊液中MMP9、TNF-α、IL-6的含量高于对照组,SOD、GSHPx的含量低于对照组且与淋巴细胞亚群含量具有良好的相关性（P〈0.05）。结论：病毒性脑炎患儿脑脊液中CD4^＋/CD8^＋T淋巴细胞比例以及NK细胞含量降低、B淋巴细胞含量增加,淋巴细胞亚群含量与MRI表现、炎症反应程度、氧化应激反应具有抑制性。

Objective：To study the lymphocyte subset contents in cerebrospinal fluid of children with viral encephalitis and their correlation with disease.Methods：Children with viral encephalitis were selected as VE group,children excluded of central nervous system infection by lumbar puncture or children without central nervous system diseases but receiving surgery with spinal anesthesia were selected as control group,and then cerebrospinal fluid and serum were collected to detect lymphocyte subset contents,nerve injury molecule contents as well as inflammatory response indicators and oxidative stress response indicators.Results：CD3^＋,CD3^＋CD4^＋,CD4/CD8 and CD16^＋CD56^＋in cerebrospinal fluid of VE group were lower than those of control group,and both CD3^＋CD8^＋ and CD19^＋ were higher than those of control group;CD3^＋,CD3^＋CD4^＋,CD4/CD8 and CD16^＋CD56^＋ in cerebrospinal fluid of children with abnormal MRI were lower than those of children with normal MRI,and both CD3^＋CD8^＋and CD19^＋were higher than those of children with normal MRI;NSE,MBP,S-100 and NPT contents in cerebrospinal fluid and serum of VE group were significantly higher than those of control group and had good correlation with lymphocyte subset contents;MMP9,TNF-αand IL-6 contents in cerebrospinal fluid of VE group were significantly higher than those of control group,and SOD and GSH-Px contents were significantly lower than those of control group and had good correlation with lymphocyte subset contents.Conclusion：CD4^＋/CD8^＋T lymphocyte ratio and NK cell content decrease,and B lymphocyte content increases in cerebrospinal fluid of children with viral encephalitis,and lymphocyte subset contents have inhibitory effect on MRI manifestation,degree of inflammatory response and oxidative stress response.