儿童传染性单核细胞增多症免疫功能变化与肝功能损害相关性研究

Correlation study on changes of immune function and liver damage in children with infectious mononucleosis

目的研究儿童传染性单核细胞增多症(IM)免疫功能变化与肝功能损害相关性,为肝功能损害的免疫防治提供理论依据。方法回顾性分析2017年7月至2019年7月江苏省连云港市第一人民医院诊治的85例Epstein-Barr病毒感染导致IM患儿的临床资料,按照是否并发肝功能损害将其分为肝功能损害组和无肝功能损害组。比较两组IgA、IgM、IgG、CD19^(+)B淋巴细胞、补体C3、自然杀伤(NK)细胞、T淋巴细胞亚群(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+));分析IM患儿免疫功能与肝功能损害的相关性。结果IM患儿合并肝功能损害发生率为40%(34/85)。两组IgA、IgG、IgM、CD19^(+)、CD8^(+)、CD4^(+)T、CD4^(+)/CD8^(+)及补体C3比较,差异有统计学意义(P<0.05);两组NK细胞比较,差异无统计学意义(P>0.05)。ALT水平与IgA、IgG、IgM、CD19^(+)、CD8^(+)、CD4^(+)、CD4^(+)/CD8^(+)、补体C3无相关性(P>0.05)。CD8^(+)为IM患儿并发肝功能损害的独立危险因素(OR=1.104,P<0.05)。结论IM患儿免疫系统紊乱与并发肝功能损害相关,对免疫功能紊乱患儿应加强监护,早期给予护肝及免疫调节治疗。

Objective To investigate the relationship between changes of immune function and liver function damage in children with infectious mononucleosis(IM),so as to provide a theoretical basis for prevention and treatment of liver damage.Methods Clinical data of 85 children with IM caused by Epstein-Barr virus infection in the First People’s Hospital of Lianyungang,Jiangsu Province,from July 2017 to July 2019 were selected.They were divided into liver function damage group and no liver function damage group,according to whether the occurrence of liver function damage.The expression of IgA,IgM,IgG,CD19^(+)B lymphocyte,complement component C3,natural killer(NK)cell,T lymphocyte subsets(CD4^(+),CD8^(+),and CD4^(+)/CD8^(+))were compared between two groups;and the correlation between immune function and liver function damage in children with IM was analyzed.Results The incidence of IM children complicated with liver function damage was 40%(34/85).There were statistically significant differences in IgA,IgG,IgM,CD19^(+),CD8^(+),CD4^(+),CD4^(+)/CD8^(+),and complement C3 between two groups(P<0.05);there was no significant difference between two groups(P>0.05).ALT level had no correlation with IgA,IgG,IgM,CD19^(+),CD8^(+),CD4^(+),CD4^(+)/CD8^(+),and complement C3(P>0.05).CD8^(+)was an independent risk factor for liver function damage in IM children(OR=1.104,P<0.05).Conclusion The disorder of immune system in IM children is associated with liver function damage,so it is necessary to strengthen the monitoring of the disorder of immune function in IM children,and give liver protection and immunomodulatory therapy in early stage.