儿童脑炎免疫功能检测分析及临床应用

Analysis of immune function examination in child encephalitis and its clinical application

目的观察脑炎患儿自身免疫功能的变化,探讨其免疫功能与病因的关系。方法选取145例脑炎住院患儿,根据临床表现分为轻症组97例,重症组48例;另外又根据感染源不同分为病毒性脑炎组99例,化脓性脑膜炎组46例。选择同期该院30例体检健康儿童作为对照组,采用流式细胞仪(FCM)进行T淋巴细胞亚群(CD3^+、CD4^+、CD8^+、CD4/CD8^+比值)、B淋巴细胞亚群细胞(CD19^+)、NK淋巴细胞亚群(CD16^+CD56^+)检测;采用免疫比浊法检测补体C3、C4及抗体IgA、IgG、IgM。结果脑炎组淋巴细胞亚群检测结果与对照组比较,差异有统计学意义(P<0.05)。病毒性脑炎组CD3^+、CD4^+、CD19^+的分子表达水平较化脓性脑膜炎组低,差异有统计学意义(P<0.05)。病毒性脑炎组C3、C4、IgA的表达水平较化脓性脑膜炎组减低,差异有统计学意义(P<0.05)。结论中枢神经系统感染儿童体液及细胞免疫功能均有不同程度受损,存在免疫功能下降的现象。

Objective To observe the change of immune function in child encephalitis,and to explore its relationship with etiology.Methods One hundred and forty-five children inpatients with encephalitis were selected and divided into mild group（97cases）and severe group（48cases）according to the clinical manifestations;in addition which were divided into the viral encephalitis group（99cases）and purulent meningitis group（46cases）according to different infection sources.Contemporaneous 30 healthy children undergoing physical examination were selected as the control group.The T lymphocyte subsets（CD3^＋,CD4^＋,CD8^＋,CD4/CD8^＋ratio）,B lymphocyte subsets（CD19^＋）and NK lymphocyte subsets（CD16^＋CD56^＋）were determined by flow cytometry（FCM）.C3,C4 and antibody IgA,IgG and IgM were tested by immune turbidity method.Results The lymphocyte subsets detection results had statistical difference between the encephalitis group and control group（P〈0.05）.The molecular expression levels of CD3^＋,CD4^＋and CD19^＋in the viral encephalitis group was lower than those in the purulent meningitis,the difference was statistically significant（P〈0.05）.The expression levels of C3,C4 and IgA in the viral encephalitis group were lower than those in the purulent meningitis group,the difference was statistically significant（P〈0.05）.Conclusion The humoral and cellular immune function in children patients with central nervous system infection has varying degrees of damage and the immune function decrease phenomenon exists.