免疫球蛋白对复杂型热性惊厥患儿血淋巴细胞亚群的影响

Effect of immunoglobulin on blood lymphocyte subsets in children with complex febrile seizures

目的探讨复杂型热性惊厥患儿免疫功能的变化及免疫球蛋白对外周血淋巴细胞亚群的影响。方法病例组32例选自2014年1月~2016年10月就诊于我院儿科的复杂型热性惊厥患儿,对照组为29例健康儿童。病例组患儿给予大剂量免疫球蛋白治疗(2g/kg),治疗前、治疗后抽静脉血查外周血淋巴细胞亚群CD19+B、CD20+B、CD4+T、CD8+T、CD4+/CD8+表达水平,并与对照组相比。所有患儿均在治疗后临床随访1年,了解患儿在发热时再抽搐的情况。结果与对照组比较,病例组患儿治疗前CD19+B、CD20+B淋巴细胞比例明显升高(P<0.05),CD4+T、CD4+/CD8+比例明显降低(P<0.05),CD8+T比例明显升高(P<0.05)。病例组患儿免疫球蛋白治疗后CD19+B、CD20+B淋巴细胞比例明显降低,CD4+T、CD4+/CD8+比例明显升高,CD8+T比例明显降低,与治疗前相比差异有统计学意义(P<0.05)。治疗后随访1年,病例组患儿临床有效率为90.63%。结论复杂型热性惊厥时细胞免疫功能异常,免疫球蛋白治疗能有效调节其免疫功能,具有良好的临床疗效。

Objective To analyze the changes of immune function and the effect of immunoglobulin on peripheral blood lymphocyte subsets in children with complex febrile seizures. Methods 32 children with complex febrile seizures admitted to our hospital from Jan 2014 to Oct 2016 were chosen as the case group. 29 healthy subjects were chosen as control group. The case group admitted high dose immunoglobulin（2 g/kg）. The expression of CD19＋B, CD20＋B, CD4＋T, CD8＋T, CD4＋/CD8＋ in peripheral blood of the two groups were measured before and after treatment. Results The expression of CD19＋B and CD20＋B of the case group were significantly higher than those in the control group（P〈0.05）. The expression of CD4＋T cells and CD4＋/CD8＋ decreased, meanwhile the expression of CD8＋T cells increased（P〈0.05）. After treatment with intravenous immunoglobulin, the expression of CD19＋B cells and CD20＋B cells were obviously lower than those before treatment（P〈0.05）.The expression of CD4＋T and CD4＋/CD8＋increased（P〈0.05）,while the level of CD8＋T cells decreased（P〈0.05）. Conclusion Immune dysfunction exists in children with complex febrile seizures. Immunoglobulin can regulate the immune function in children with complex febrile seizures and control the development of the disease.