慢性苯中毒致儿童再生障碍性贫血免疫功能及家庭管理方式的影响

Effects of aplastic anemia caused by chronic benzene poisoning on immune function in children and family management

目的研究慢性苯中毒致儿童再生障碍性贫血(AA)的免疫功能,并探讨家庭管理方式对其的影响。方法选择慢性苯中毒致AA儿童56例为AA组,另选同期健康检查儿童30例为对照组。检测并比较两组的外周血T淋巴细胞亚群、免疫球蛋白(IgA、IgM、IgG)水平。AA组患儿接受家庭养护管理,并采用中文版家庭管理测量量表(FaMM)评价家庭管理方式现况。结果AA组的血红蛋白(Hb)含量、白细胞(WBC)计数、红细胞(RBC)计数、血小板(PLT)计数及网织红细胞(RC)计数均低于对照组(P<0.01);AA组的CD3+、CD4+、CD4+/CD8+及血清中IgA、IgG水平均低于对照组,而CD8+、IgM高于对照组(P<0.01)。家庭健康教育后,FaMM量表中日常生活、管理能力、相互支持评分均较教育前明显提高,疾病担心、管理困难及精力消耗评分明显降低(P<0.01);家庭健康教育后,AA组患儿CD3+、CD4+、CD4+/CD8+及血清中IgA、IgG水平明显升高,CD8+、IgM明显降低(P<0.01)。结论慢性苯中毒所致AA组患儿有明显的免疫功能紊乱,家庭健康教育有利于改善家长的家庭管理方式,促进患儿免疫功能的恢复。

Objective To study the immune function of aplastic anemia(AA)in children caused by chronic benzene poisoning,and explore the influence of family management on it. Methods Fifty-six children with AA caused by chronic benzene poisoning were selected as AA group,and 30 children with health examination during the same period were selected as control group. T lymphocyte subsets and immunoglobulin(IgA,IgM,IgG)levels in peripheral blood of the two groups were detected and compared. Children in the AA group received family maintenance management,and family management measure(FaMM)was used to evaluate the status of family management. Results Hemoglobin(Hb)content,white blood cells(WBC)count,red blood cells(RBC)count,platelet(PLT)count and reticulocyte(RC)count in the AA group were all lower than those in the control group(P<0.01). The levels of CD3+,CD4+,CD4+/CD8+ and serum IgA and IgG in the AA group were lower than those in the control group,while the levels of CD8+ and IgM were higher than those in the control group(P<0.01). After family health education,scores of daily life,management ability and mutual support in FaMM scale were significantly higher than those before education,while scores of disease concern,management difficulty and energy consumption were significantly lower(P<0.01). After family health education,the levels of CD3+,CD4+,CD4+/CD8+ and serum IgA and IgG in children in the AA group increased significantly,while the levels of CD8+ and IgM decreased significantly(P<0.01). Conclusions Children with AA caused by chronic benzene poisoning had significant immune dysfunction. Family health education can improve parents’ family management mode and promote the recovery of children’s immune function.