传染性单核细胞增多症和传染性单核细胞综合征患儿PD-1以及Tregs差异比较

Comparison of PD-1 and Tregs in children with infectious mononucleosis and infectious monocyte syndrome

目的探讨传染性单核细胞增多症(IM)患儿和传染性单核细胞综合征(IMS)患儿程序性死亡受体1(PD-1)以及调节性T细胞(Tregs)的差异。方法选择2016年1月至2019年9月大连市中心医院儿科收治的IM患儿40例与IMS患儿40例为观察对象。IMS组男24例,女16例,年龄(5.11±4.07)岁;IM组男22例,女18例,年龄(8.33±5.32)岁。流式细胞术检测外周血T淋巴细胞亚群百分数、Tregs细胞百分数以及CD4^(+)T和CD8^(+)T细胞PD-1的表达水平。希森美康XE-2100进行外周血细胞分类检测,用奥林巴斯显微镜进行异型淋巴细胞计数,采用散射比浊法检测血清免疫球蛋白G(IgG)、IgM、IgA,补体C3和C4水平。结果IM组外周血CD3^(+)CD8^(+)T细胞百分数、CD3^(+)T细胞百分数、CD8^(+)PD-1^(+)细胞百分数、PD-1^(+)细胞百分数、白细胞计数[(17.83±8.81)比(7.81±4.82)×10^(9)/L]、淋巴细胞百分数[(63.49±15.61)%比(44.21±13.80)%]、淋巴细胞绝对值[(10.29±2.91)比(3.28±1.63)×10^(9)/L]、异型淋巴细胞百分数[(19.23±11.24)%比(0.78±0.90)%]、抗体水平[IgG:(1314.86±408.14)比(874.46±222.10)mg/dl,IgA:(206.53±81.31)比(10^(9).24±73.26)mg/dl]都较IMS组明显升高,差异均有统计学意义(均P<0.05);而CD3^(+)CD4^(+)T细胞、Tregs细胞百分数和补体水平[补体C3:(85.52±8.53)比(103.85±13.01)mg/dl;补体C4:(20.84±1.31)比(28.36±6.81)mg/dl]较IMS组明显降低,差异均有统计学意义(均P<0.05)。结论IM患儿较IMS患儿免疫细胞PD-1的表达明显增高,Tregs明显下降,为临床鉴别诊断以及疾病治疗提供依据。

Objective To investigate the differences of programmed cell death-1(PD-1)and regulatory T cells(Tregs)between children with infectious mononucleosis(IM)and infectious monocyte syndrome(IMS).Methods A total of 40 children with IM and 40 children with IMS treated in the Department of Pediatrics of Dalian Municipal Central Hospital from January 2016 to September 2019 were selected as the objects of observation.There were 24 males and 16 females in the IMS group,with an age of(5.11±4.07)years old.There were 22 males and 18 females in the IM group,with an age of(8.33±5.32)years old.The percentage of T lymphocyte subsets,the percentage of Tregs,and the expressions of PD-1 in CD4^(+)T and CD8^(+)T cells of the peripheral blood were detected by flow cytometry.SYSMEX XE-2100 was used to detect the classification of peripheral blood cells,Olympus microscope was used to count the atypical lymphocytes,and nephelometry was used to detect the levels of serum immunoglobulin G(IgG),IgM,IgA,and complement C3 and C4.Results In the IM group,the percentage of CD3^(+)CD8^(+)T cells,the percentage of CD3^(+)T cells,the percentage of CD8^(+)PD-1^(+)cells,the percentage of PD-1^(+)cells,white blood cell count[(17.83±8.81)vs.(7.81±4.82)×10^(9)/L],the percentage of lymphocytes[(63.49±15.61)%vs.(44.21±13.80)%],the count of lymphocytes[(10.29±2.91)vs.(3.28±1.63)×10^(9)/L],the percentage of atypical lymphocytes[(19.23±11.24)%vs.(0.78±0.90)%],and antibody levels[IgG:(1314.86±408.14)vs.(874.46±222.10)mg/dl,IgA:(206.53±81.31)vs.(10^(9).24±73.26)mg/dl]were all significantly higher than those in the IMS group(all P<0.05);the percentage of CD3^(+)CD4^(+)T cells,the percentage of Tregs,and complement levels[complement C3:(85.52±8.53)vs.(103.85±13.01)mg/dl;complement C4:(20.84±1.31)vs.(28.36±6.81)mg/dl]in the IM group were all significantly lower than those in the IMS group(all P<0.05).Conclusion The expression of PD-1 in the immune cells of IM children is significantly higher than that of IMS children,and the expression of Tregs is significantly lower,which provide a basis for clinical differential diagnosis and disease treatment.