不同病原体呼吸道感染患儿外周血淋巴细胞亚群差异分析

Difference in peripheral blood lymphocyte subsets of children with respiratory tract infection caused by different pathogens

目的分析不同病原呼吸道感染患儿外周血淋巴细胞亚群的差异。方法选取94例明确为单一病原体呼吸道感染患儿为研究对象,其中细菌感染47例(包括金黄色葡萄球菌13例、链球菌16例、嗜血流感杆菌18例),病毒感染47例(包括呼吸道合胞病毒15例、腺病毒13例、人副流感病毒19例)。另选同期性别、年龄相匹配的40例健康体检儿童为对照组。采用流式细胞分析仪及淋巴细胞亚群试剂盒检测并计算儿童外周血CD45^+、CD3^+、CD3^+CD8^+、CD3^+CD4^+、CD3^-CD19^+、CD3^-CD56/16^+绝对计数,CD3^+、CD3^+CD8^+、CD3^+CD4^+、CD3^+CD4^-CD8^-、CD3^-CD19^+、CD3^-CD56/16^+比例及CD4^+/CD8^+比值。结果3组对象外周血CD3^+CD8^+绝对计数比较,差异有统计学意义(均P<0.05),其中病毒感染组明显低于对照组(P<0.05);3组对象外周血其余淋巴细胞亚群绝对计数比较,差异均无统计学意义(均P>0.05)。除外周血CD3^-CD19^+比例外,3组对象其余淋巴细胞亚群比例比较差异均有统计学意义(均P<0.05),其中病毒感染组和细菌感染组CD3^+、CD3^+CD8^+比例均低于对照组(均P<0.05),CD4^+/CD8^+明显高于对照组(P<0.05),细菌感染组CD3^-CD56/16^+高于对照组(P<0.05)。不同种类细菌感染组与对照组外周血CD3^+CD8^+、CD3^+CD4^-CD8^-比例及CD3^-CD56/16^+、CD4^+/CD8^+比较,差异均有统计学意义(均P<0.05)。不同种类病毒感染组与对照组外周血CD3^+CD8^+、CD3^+CD4^+、CD3^+CD4^-CD8^-比例及CD4^+/CD8^+比较,差异均有统计学意义(均P<0.05)。结论不同病原体呼吸道感染患儿外周血淋巴细胞亚群存在差异;外周血淋巴细胞亚群检测结果能反映患儿机体免疫状态,对于指导小儿呼吸道感染的诊治具有临床意义。

Objective To analyze the difference of lymphocyte subsets in peripheral blood of children with respiratory tract infection caused by different pathogens.Methods Ninety four children with a single pathogen^-specific respiratory infection were enrolled.There were 47 cases of bacterial infection,including 13 cases caused by Staphylococcus aureus,16 cases caused by Streptococcus,18 cases caused by Haemophilus influenzae,and 47 cases of viral infection,including 15 cases caused by syncytial virus,13 cases caused by adenovirus,19 cases caused by parainfluenza virus.Forty gender and age^-matched healthy children were selected as the control group.The absolute counts of CD45^+,CD3^+,CD3^+CD8^+,CD3^+CD4^+,CD3^-CD19^+,CD3^-CD56/16^+cells in peripheral blood were measured and calculated by flow cytometry and lymphoid subgroup kit.The percentages of CD45^+,CD3^+,CD3^+CD8^+,CD3^+CD4^+,CD3^-CD19^+,CD3^-CD56/16^+and CD4^+/CD8^+were also calculated.Results There was significant difference in the absolute count of CD3^+CD8^+in peripheral blood among the three groups(P<0.05),and the infection group was significantly lower than the control group(P<0.05).Except the ratio of CD3^-CD19^+in peripheral blood,the percentages of other lymphocyte subsets in the three groups were significantly different(all P<0.05).The ratio of CD3^+and CD3^+CD8^+in viral infection group and bacterial infection group were lower than that in the control group(all P<0.05),CD4^+/CD8^+were significantly higher than that in the control group(all P<0.05),and the ratio of CD3^-CD56/16^+in bacterial infection group was higher than that in the control group(P<0.05).There were significant differences in the ratio of CD3^+CD8^+,CD3^+CD4^-CD8^-and the ratio of CD3^-CD56/16^+,CD4^+/CD8^+between different kind of bacterial infection groups and control group(all P<0.05).There were significant differences in the ratio of CD3^+CD8^+,CD3^+CD4^+,CD3^+CD4^-CD8^-and CD4^+/CD8^+between different virus infection groups and control group(P<0.05).Conclusion There are differences in peripheral blood lymphocyte subsets of children with respiratory tract infection caused by different pathogens,which can reflect the immune status of patients and is of clinical value for guidance of treatment in children with respiratory tract infection.