儿童支气管肺炎患儿体液免疫、细胞免疫功能变化及临床意义

Changes of humoral and cellular immune functions in children with bronchopneumonia and clinical sig-nificance

目的探讨支气管管肺炎患儿细胞免疫、体液免疫指标变化和临床意义.方法选择2016年4月至2018年9月在菏泽市立医院儿科就诊的支气管肺炎患儿60例,同时选择健康体检儿童60例为作为对照组,应用免疫速率散射浊度法对全部治疗不同阶段研究对象的免疫球蛋白(immunoglobulin,Ig)M、IgA、IgG进行检测;六色流式细胞术检测CD3^+、CD4^+/CD8^+、CD3^+/CD4^+、CD3^+/CD8^+等细胞免疫指标,比较观察组治疗前、治疗中、治疗后与对照组相应指标的变化.同时酶联免疫吸附实验法比较两组研究对象白细胞介素10(inteuleukin-10,IL-10)、白细胞介素6(interleukin-6,IL-6)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)等水平变化情况.结果观察组患儿治疗前、治疗中、治疗后的IgM、IgA、IgG水平均低于对照组,随着治疗的进展,观察组患儿的Ig水平不断升高,差异有统计学意义(P<0.05);观察组患儿治疗前、治疗中、治疗后组的CD3^+、CD4^+/CD8^+、CD3^+/CD4^+等细胞免疫指标水平低于对照组,而CD3^+/CD8^+指标显著高于对照组,差异均有统计学意义(均P<0.05).观察组患儿的IL-10、IL-6、TNF-α等细胞因子水平显著高于对照组,差异有统计学意义(P<0.05).结论支气管肺炎患儿均出现不同程度的细胞免疫、体液免疫指标失衡,检测患儿的免疫功能指标可评估支气管肺炎患儿的治疗效果及预后.

Objective To investigate the changes of cellular immunity and humoral immune function in children with bronchopneumonia and to analyze the clinical significance. Methods From April 2016 to Sep-tember 2018,60 patients with bronchial pneumonia in Heze City Hospital were recruited as observation group, and 60 healthy children were enrolled as control group. Immunoglobulin M(IgM),IgA and IgG were detected by immune rate turbidimetric method. Six-color flow cytometry was used to detect CD3^+,CD4^+/ CD8^+,CD3^+/ CD4^+and CD3^+/ CD8^+ in all subjects,the changes of indicators before treatment,during treatment and after treatment in the observation group and the control group were compared. At the same time,the levels of interleukin 10 (IL-10),interleukin 6(IL-6)and tumor necrosis factor α(TNF-α)in two groups were compared too. Results Before treatment,during treatment and after treatment,IgM,IgG of the patients in the observation group was lower than that of the control group,the difference was statistically significant(all P < 0. 05). As the treatment progresses,IgM ,IgA and IgG of the patients in the observation group increased,while the levels of the cells with CD3^+,CD4^+/ CD8^+ and CD3^+/ CD4^+ in the observation group were significantly lower than those in the con-trol group,the difference was statistically significant( P < 0. 05),the CD3^+/ CD8^+ index in the observation group was significantly higher than that in the control group(P < 0. 05). The level of IL-10,IL-6 and TNF-αin the observation group were significantly higher than those in the control group(all P < 0. 05). Conclusion Children with bronchopneumonia showed different degrees of imbalance of cellular immunity and humoral im-mune. Detection of children's immune function index may be used to evaluate the therapeutic effect and the prognosis of children with bronchial pneumonia.