儿童传染性单核细胞增多症患者外周血T细胞、血浆PD-1和Tim-3水平表达检测的临床意义

Clinical Significance of Detecting PD-1 and Tim-3 Expression of T Cells and Plasma in Peripheral Blood from Children with Infectious Mononucleosis

目的探讨儿童传染性单核细胞增多症(infectious mononucleosis,IM)患者外周血T细胞、血浆PD-1和Tim-3表达检测的临床意义。方法采集67例IM患儿和20例健康对照者的外周血,流式细胞仪检测PD-1和Tim-3在CD4^(+)和CD8^(+)T细胞上的表达,ELISA法检测血浆PD-1和Tim-3的浓度。结果与对照组比较,IM组CD4^(+)T和CD8^(+)T细胞上PD-1和Tim-3表达百分比、血浆PD-1和Tim-3浓度均明显增加(t=7.646~23.161,均P<0.01)。ROC曲线分析,血浆PD-1和Tim-3诊断IM的界值分别为1.24 ng/ml和0.44 ng/ml,敏感度分别为62.7%和65.7%,特异度分别为85.0%和75.0%。结论IM患儿的免疫抑制与PD-1及Tim-3表达增高有关,血浆PD-1和Tim-3浓度对诊断IM具有一定的价值。

Objective To explore theexpression changes of PD-1 and Tim-3 of T cells and plasma inperipheral blood and their clinical significance in children with infectious mononucleosis(IM).Methods The percentage of PD-1,Tim-3 on CD4^(+)and CD8^(+)T cells were analyzed by flow cytometry,plasma concentrations of PD-1 and Tim-3 were tested by ELISA inperipheral blood in 67 children with IM and 20 healthy controls.Results Compared with control group,the percentage of PD-1,Tim-3 on CD4^(+)and CD8^(+)T cells and plasma concentrations of PD-1 and Tim-3 were increased(t=7.646~23.161,all P<0.01)in children with IM.ROC curve analysis of plasma PD-1 and Tim-3 yielded cut-off value of for discriminating IM were 1.24 ng/ml and 0.44 ng/ml with sensitivity being 62.7%and 65.7%and specificity being 85.0%and 75.0%,respectively.Conclusion The increased expression of PD-1 and Tim-3 were associated with immunosuppression in children with IM.Plasma concentrations of PD-1 and Tim-3 have certain value in diagnosis for IM.