T淋巴细胞亚群与调节性B细胞在儿童手足口病中的表达及临床意义

Expression and clinical significance of lymphocyte subsets and regulatory B cells in children with hand,foot and mouth disease

目的探讨调节性B细胞(Breg)在儿童手足口病中的作用,为临床治疗提供参考依据。方法选取2015年4月-2015年7月就诊的手足口病患儿71例为观察组,另选取50例健康儿童为对照组,治疗康复后的62例为康复组;用流式细胞术检测手足口病患儿外周血T淋巴细胞亚群细胞表达情况。同时用ELISA方法分析血清白细胞介素(IL-10)、转化生长因子-β(TGF-β)分泌水平。结果手足口病患儿T淋巴细胞亚群CD_3^+CD_8^+CD_(28)^+细胞毒T细胞的表达,重症患儿和普通型患儿组较对照组增高(P<0.01),重症患儿又显著高于普通型患儿组(P<0.01);相关性分析显示,手足口病患儿Breg细胞表达水平与血清IL-10呈显著正相关(r=0.75,P<0.01),与血清TGF-β无相关性,与CD_3^+CD_8^+CD_(28)^+细胞毒T细胞表达水平呈显著性负相关(r=-0.74,P<0.01)。结论手足口病患儿存在显著免疫失衡,即CD_3^+CD_8^+CD_(28)^+细胞毒T细胞显著增多,可能与Breg细胞表达减低导致的免疫抑制功能不足有关;Breg细胞表达水平分析有助于手足口病的诊断、进展和预后评估。

OBJECTIVE To investigate the role of CD^19＋CD^24^highCD^27＋ regulatory B cells in children with hand,foot and mouth disease（HFMD）,so as to provide references for clinical treatment.METHODS A total of 71 cases of HFMD patient admitted from Apr.2015 to Jul.2015 were chosen as the observation groups,50 healthy children were set as control group and 62 patients who rehabilitated after treatment were chosen as the rehabilitation group.The peripheral blood T-cell subsets of patients were determined by flow cytometry,and the serum levels of interleukin-10（IL-10）and teansforming growth factor-β（TGF-β）were measured by enzyme-1inked immunosorbent assay（ELISA）.RESULTS The severe and mild HFMD patients had significantly higher percentage of CD3^＋CD8^＋CD28^＋ T cells（P〈0.01）than that of control group,and the severe childres had significantly higher percentage of CD3^＋CD8^＋CD28^＋ T cells than that of mild ohildren（P〈0.01）.Correlation analysis showed that the percentage of Breg expression was positively correlated with the serum level of IL-10（r=0.75,P〈0.01）,and was negatively correlated with the percentage of CD3^＋CD8^＋CD28^＋ T cells（r=-0.74,P〈0.01）.CONCLUSIONThere is obvious immune imbalance in HFMD children,that the significant increase of CD3^＋CD8^＋CD28^＋ T cells may be correlated with the decreased expression of Breg cells and its insufficient of immunosuppression function.Analysis of Breg cell expression contributes to the diagnosis,progress and prognosis evaluation of HFMD.