徐州及周边地区儿童淋巴细胞亚群正常参考区间调查

Investigation on normal reference intervals of lymphocyte subsets in children in Xuzhou and surrounding areas

目的建立徐州及周边地区不同年龄段儿童淋巴细胞亚群(TBNK)的正常参考区间.方法采集徐州及周边地区1378名受检儿童的外周血样本,采用流式细胞术测定TBNK细胞比例和细胞计数,统计并分析不同年龄段儿童的TBNK(CD3^(+)、CD3^(+)CD4^(+)、CD3^(+)CD8^(+)、CD3-CD19^(+)、CD3-CD16/56^(+)细胞)正常参考区间和变化趋势.结果①CD3^(+)细胞比例在新生儿期(≤4周)没有显著变化,婴儿期(5周~5个月)与新生儿期比较明显降低〔69.70%(56.98%,79.46%)比81.12%(69.63%,89.82%),P<0.05〕,之后一直持续到青春期无明显变化;CD3^(+)细胞计数从幼儿期(1~2岁)至青春期(12~17岁)结束逐渐降低.②CD3^(+)CD4^(+)细胞比例在新生儿期最高〔58.18%(44.01%,71.44%)〕,从婴儿期至学龄前期(3~5岁)逐渐降低,学龄期(6~11岁)至青春期无明显变化;CD3^(+)CD4^(+)细胞计数在1周~12个月明显高于<1周〔×10^(9)/L:2.19(0.98,3.65)比1.60(0.77,2.83),P<0.05〕,之后则逐渐降低.③CD3^(+)CD8^(+)细胞比例在6个月内没有显著变化,从6个月至学龄期逐渐增高,青春期又较学龄期降低;CD3^(+)CD8^(+)细胞计数则呈现先升高后降低的趋势.④CD3-CD19^(+)细胞比例在新生儿期较低〔9.85%(4.11%,19.80%)〕,从6个月后至青春期呈波动变化;CD3-CD19^(+)细胞计数也呈先升高后降低的趋势,在6~12个月最高〔1.15(0.53,2.13)×10^(9)/L〕.⑤CD3-CD16/56^(+)细胞比例和细胞计数均呈波动变化.⑥CD3^(+)CD4^(+)细胞/CD3^(+)CD8^(+)细胞比值(CD4^(+)/CD8^(+))在新生儿期最高〔2.76(1.33,5.72)〕,之后逐渐降低,至青春期略有上升.⑦CD3^(+)CD4^(+)CD8^(+)细胞比例和计数变化规律不明显.结论通过临床检测和数据分析得到了8个不同年龄阶段分组样本的TBNK细胞比例和计数的正常参考区间.TBNK变化趋势的规律及影响因素还待进一步探讨研究.

Objective To establish the nonnal reference intervals of lymphocyte subsets(TBNK)in children of different ages in Xuzhou and surrounding areas.Methods The peripheral blood samples of 1378 children were collected from Xuzhou City and its peripheral area and the flow cytometry was used to detect the cell proportion and cell count of TBNK(CD3^(+),CD3^(+)CD4^(+),CD3^(+)CD8^(+),CD3^(+)CD19^(+)and CD3_CD16/56^(+)cells).The normal reference intervals and variation trends of TBNK in children of different ages were statistically analyzed.Results①The proportion of CD3^(+)cells did not change significantly during the neonatal period(W4 weeks),but the proportion in early infancy period(5 weeks-5 months)was significantly lower than that in neonatal period[69.70%(56.98%,79.46%)vs.81.12%(69.63%,89.82%),P<0.05].Afterwards,there was no significant change until puberty.The gradual decreasing trend of CD3^(+)cell count from early childhood(1-2 years)to the adolescence(12-17 years)reached the end.②The proportion of CD3^(+)CD4^(+)cells was the highest[58.18%(44.01%,71.44%)]during the neonatal period,but gradually decreased from infancy to preschool age(3-5 years),while there was no significant change between school age(6-12 years)and adolescence.The CD3^(+)CD4^(+)cells count from 1 week-12 months old was significantly higher than that of<1 week old[X 109/L:2.19(0.98,3.65)vs.1.60(0.77,2.83),P<0.05],and then decreased gradually.③The proportion of CD3^(+)CD8^(+)T cells did not change significantly within 6 months,but increased gradually from 6 months to school age,and then decreased during puberty compared with the proportion in school age.The CD3^(+)CD8^(+)cell count presented the trend of firstly increasing and then decreasing.④The proportion of CD3~CD19^(+)cells was relatively low during the neonatal period[9.85%(4.11%,19.80%)]and fluctuated from 6 months onward to adolescence;the CD3 CD19^(+)cell count also showed a trend of firstly increasing and then decreasing,and reached the highest level during 6-12 months[1.15(0.53,2.13)X 109/L].⑤The proportion and count of CD3-CD16/56^(+)cells all showed a trend of fluctuation change.⑥The highest ratio of CD3^(+)GD4^(+)cells to CD3^(+)CD8^(+)cells(CD4^(+)/CD8。was in the neonatal period[2.76(1.33,5.72)],then the ratio gradually decreased,and there was a slight increase during adolescence.⑦The proportion and count of CD3^(+)CD4^(+)CD8^(+)cells did not change significantly.Conclusions The normal reference intervals of proportion and count of TBNK are obtained by data analysis and clinical detection on blood samples collected from 8 age groups of children.However,the rules of TBNK changing tread and its influencing factors are necessary to be further studied.