MP对HSP患儿T细胞亚群、促炎因子及临床症状的影响

Influence of MP on T-cell Subsets, Pro-Inflammatory Cytokines and Clinical Symptoms in Children with HSP

目的:探讨支原体感染(MP)对过敏性紫癜(HSP)患儿的T细胞亚群、炎症因子及临床症状的影响。方法:96例HSP患儿分为MP阳性组(A组,30例)与MP阴性组(B组,66例),对比其T细胞亚群中CD3^+、CD4^+、CD8^+、CD19^+及NK(16^+^+56^+)的百分比,及血清炎症因子IL-6、IL-17、TGF-β水平,比较两组患儿的皮疹消退时间、住院时间及随访期间不良症状的发生率。结果:两组T细胞亚群中CD3^+、CD4^+、CD19^+的百分率不存在显著差异(P>0.05),而A组的CD8^+、CD4^+/CD8^+、CD(16^+^+56^+)则低于B组(P<0.05)。A组IL-6、IL-17明显高于B组(P<0.05),两组的TGF-β则未见显著差异(P>0.05)。A组皮疹消退时间、住院时间显著高于B组,住院及随访期间腹痛、关节痛、复发等不良症状的发生率也均高于B组(P<0.05)。结论:MP感染可抑制NK免疫细胞活性,促进Th17等炎症因子的分泌,加重T细胞亚群的失衡,导致B细胞过度增殖,引起HSP患儿更为严重的免疫功能紊乱,导致更为严重的临床反应。

Objective： To investigate the effect of mycoplasma infection（MP） on T cell subsets, inflammatory factors and clinical symptoms in children with allergic purpura（HSP）. Methods： 96 cases of HSP were divided into MP positive group（30 cases in group A, MP） and negative group（group B, 66 cases）, CD3^＋, CD4^＋, CD8^＋, CD19^＋ and NK subsets in contrast to its T cell（16＋＋56＋） percentage and serum inflammatory factors IL-6, IL-17 and TGF- levels. Comparison of two groups of children with skin rash subsided time, hospitalization time and the incidence of adverse symptoms during the follow-up period. Results： There were no significant differences in the percentages of CD3^＋, CD4^＋, and CD19^＋ in the two groups of T cell subsets（P〉0.05）, while the CD8^＋, CD4^＋/CD8^＋, CD（16^＋-＋56^＋） of A group was lower than that of B group（P〈0.05）. A group IL-6, IL-17 was significantly higher than B group（P〉0.05）, the two group of TGF- beta did not show significant difference（P〉0.05）. The time of rash subsided and hospital stay in group A were significantly higher than those in B group, and the incidence of abdominal pain, joint pain, recurrence and other adverse symptoms during hospitalization and follow-up were higher than that in group B（P〈0.05）. Conclusion： MP infection can inhibit the NK activity of immune cells, promote the secretion of Th17 and other inflammatory factors, aggravate the imbalance of T cell subsets, lead to excessive proliferation of B cells, resulting in HSP group is more serious immune dysfunction, leading to a more severe clinical response.