儿童青紫型与非青紫型先天性心脏病胸腺病理及免疫功能的对比观察

Comparison of pathology and immune function of thymus in children with cyanotic and non-cyanotic congenital heart disease

目的探讨儿童青紫型与非青紫型先天性心脏病患者的胸腺病理及免疫功能,为疾病诊治提供依据。方法选取2016年5月~2017年3月我院收治的30例青紫型先心病患儿(A组)与40例非青紫型先心病患儿(B组)作为研究对象。比较两组患儿的CD3、CD4、CD8、CD19、NK细胞及杀伤T细胞水平,观察比较两组的手术切除胸腺常规病理组织形态变化。结果 B组患儿的淋巴细胞计数、CD3、CD4、CD8、CD19、NK细胞及杀伤T细胞计数均高于A组,差异有统计学意义(P<0.05)。两组1~2岁患儿的淋巴细胞计数、CD3、CD4、CD8、CD19、NK细胞及杀伤T细胞计数均低于同组0~1岁患儿,差异有统计学意义(P<0.05)。两组患儿病理检查可见胸腺结构存在,皮髓境界清楚,皮质淋巴细胞丰富,髓质胸腺小体结构存在,间质无著变,B组1~2岁患儿可见少量星空现象和胸腺轻度萎缩,A组0~1岁患儿可见星空现象和胸腺轻度萎缩,A组1~2岁患儿可见较多星空现象和胸腺明显萎缩。结论青紫型先心病患儿较非青紫型先心病胸腺萎缩明显而免疫功能降低,且先心病患儿胸腺萎缩和免疫功能低下随年龄增长而加重。

Objective To investigate the pathology and immune function of thymus in children with cyanotic and non- cyanotic congenital heart disease,and to provide basis for the diagnosis and treatment of disease.Methods 30 patients with cyanotic congenital heart disease （group A） and 40 patients with non-cyanotic congenital heart disease （group B） treated in our hospital from May 2016 to March 2017 were selected as subjects.The CD3,CD4,CDS,CD19,NK cells and cytotoxic T cells counts in two groups were detected and compared.The hist opathological changes of thymus in two groups were observed and compared.Results The CD3,CD4,CD8,CD19,NK cells and cytotoxic T cells counts in group B were higher than those of group A,and the differences were significant （P〈O.OS）.The CD3,CD4,CD8,CD19,NK cells and cytotoxic T cells counts in children aged 1-2 years in both groups were lower than those of 0-1 years old children in the two groups,and the differences were significant （P〈0.05）.Pathological examination resaults showed that both of the two groups had thymus structure exists,clear edge state,rich cortical lymphocytes,medullary thymus body structure exists,and no interstitial change,besides group B aged 1-2 years old children had small number of stars and thymus mild atrophy,group A aged 0-1 years old children had stars phenomenon and thymus mild atrophy,and group A aged 1-2 years old children had much stars and thymus atro- phy.Conclusion Thymic atrophy in children with cyano.tic congenital heart disease are severe than that of the children with non-cyanotic congenital ~heart disease,and immune function in children with cyanotic congenital heart disease are lower than those of the children with non-cyanotic congenital heart disease.And the thymic atrophy and immune function lowering of children with congenital heart disease are aggravated with age.