哮喘患儿外周血淋巴细胞亚群和CD4^+ T细胞亚群的变化情况

Changes of peripheral blood lymphocyte subsets and CD4^+ T cell subsets in children with asthma

目的小儿哮喘的发生发展受免疫系统的影响,本文探讨哮喘患儿外周血淋巴细胞亚群和CD4^+T细胞亚群的变化情况,探讨其临床意义。方法选择2013年1月—2015年12月哮喘患儿80例作为哮喘组,健康体检儿童80例作为对照组。测定外周血淋巴细胞亚群和CD4^+T细胞亚群含量。结果哮喘组CD3^+、CD4^+、CD19^+、CD4^+/CD8^+[(62.13±11.24)%、(32.97±6.57)%、(24.35±11.21)%、(1.66±0.31)%]高于对照组[(71.16±12.64)%、(37.68±7.12)%、(13.87±8.46)%、(1.43±0.28)%,P<0.05],哮喘组CD8^+[(19.87±4.21)%]低于对照组[(26.37±4.65)%。P<0.05]。哮喘组Th2、Th17、Treg、Th17/Treg[(4.42±2.14)%、(1.71±0.97)%、(7.65±1.35)%、(0.22±0.05)%]均高于对照组[(1.96±1.25)%、(0.89±0.42)%、(5.91±1.28)%、(0.15±0.03)%,P<0.05],哮喘组Th1/Th2[(1.31±1.32)]低于对照组[(2.70±1.47),P<0.05],2组Th1比较差异无统计学意义(P>0.05)。哮喘组淋巴细胞[(36.57±13.24)%]低于对照组[(59.64±15.47)%,P<0.05],哮喘组单核细胞[(12.17±4.21)%]高于对照组[(3.68±1.74)%,P<0.05],2组白细胞和中性粒细胞比较差异无统计学意义(P>0.05)。淋巴细胞与Th1、Th2、Th17呈负相关(P<0.05),单核细胞与CD3^+、CD4^+、CD19^+呈负相关(P<0.05),与CD8^+呈正相关(P<0.05)。结论哮喘患儿存在淋巴细胞亚群和CD4^+T细胞亚群异常,外周血淋巴细胞亚群和CD4^+T细胞亚群含量可用于哮喘患儿免疫功能判断。

Objective The development of asthma in children is affected by the immune system, the aim of this paper is to investigate the changes of peripheral blood lymphocyte subsets and CD4^＋ T cell subsets and it clinical significance in children with asthma. Methods Eighty children with asthma （ asthma group） and 80 healthy children （ control group） in our hospital from January, 2013 to December, 2015 were enrolled into this study. The peripheral blood lymphocyte subsets and CD4^＋ T cell subsets were measured. Results The levels of CD3^＋ , CD4^＋ , CD19^＋ , CD4^＋/CD8^＋ in asthma group were （62.13±11.24） %, （ 32.97±6.57 ） %, （ 24.35± 11.21 ） % and （ 1.66±0.31 ） %, respectively, which were signifi- cantly higher than those in control group [ （ 71.16±12.64 ） %, （ 37.68± 7. 12 ） %, （ 13.87±8.46 ） %, （ 1.43±0.28 ） % ,P 〈 0.05 ]. The level of CD8^＋ （ 19.87% ±4.21% ） in asthma group was lower than that in control group （26.37±4.65% ）,P 〈0.05. The levels of Th2,Th17,Treg,Thl7/Treg in the asthma group were （4.42±2.14）%, （ 1.71± 0.97 ） %, （7.65 ± 1.35 ） % and （ 0.22± 0.05 ） %, respectively, which were higher than those in the control group[ （1.96± 1.25）%, （0.89±0.42）% ,（5.91± 1.28）%, （0.15±0.03）% ,P 〈0.05]. The Thl/Th2（1.31±1.32% ） in the asthma group was lower than that in the control group （2.70±1.47% ）, P 〈 0.05. There was no significant difference in Thl between the two groups（ P 〉 0.05 ）. The lymphocytes in the asthma group（ 36.57± 13.24% ）was signif- icantly lower than that in the control group （59.64%±15.47% ）, P 〈 0.05, the monocytes in the asthma group （12.17±4.21% ）was higher than the control group （3.68%± 1.74% ）, P 〈 0.05. There was no significant difference in white blood cells and neutrophils between the two groups（ P 〉 0.05 ）. The lymphoeytes were negatively correlated with Th1, Th2 and Th17 （ P 〈 0.05 ）. The monocytes were negatively correlated with CD3^＋ , CD4^＋ and CD19^＋ （ P 〈 0.05 ）, and was pos- itively correlated with CD8^＋ （P 〈 0.05）. Conclusion The lymphocyte subsets and CD4^＋ T cell subsets in children with asthma are abnormal. Peripheral blood lymphocyte subsets and CD4^＋ T cell subsets can be used to determine the immune function of children with asthma.