T淋巴细胞亚群联合细胞因子在HPS诊断中的应用

Application of T lymphocyte subsets combined with cytokines in the diagnosis of hemophagocytic syndrome

目的探讨外周血T淋巴细胞亚群联合细胞因子在嗜血细胞综合征(hemophagocytic syndrom,HPS)诊断中的应用。方法采用回顾性分析法,29例HPS患儿为研究组,同期因发热住院的非HPS患儿30例为对照组,同期体检的健康儿童28例为健康组。比较3组分化簇3(cluster of differentiation 3,CD3^(+))、分化簇4(cluster of differentiation4,CD4^(+))、分化簇8(cluster of differentiation 8,CD8^(+))、CD4^(+)/CD8^(+)及γ-干扰素(Interferon-γ,IFN-γ)、白细胞介素-2(Interleukin-2,IL-2)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平。结果研究组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组及健康组(t=1.781、2.957、2.844,P<0.05;t=3.328、9.380、9.443,P<0.05);CD8^(+)水平低于对照组(t=-3.251,P<0.05;t=-4.752,P<0.05)。研究组外周血IFN-γ、IL-2、TNF-α水平高于对照组(t=4.315、12.122、16.001,P<0.05);研究组高于健康组(t=8.328、21.956、21.028,P<0.05)。预后良好组外周血CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)T水平及IFN-γ、IL-2、TNF-α水平均低于预后不良组(P<0.05),CD8^(+)水平高于预后不良组(P<0.05)。结论外周血CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)及IFN-γ、IL-2、TNF-α水平越高和CD8^(+)比例越低可提示HPS及较差的预后。

Objective To explore the application value of peripheral blood T lymphocyte subsets combined with cytokines in the diagnosis of hemophagocytic syndrome(HPS).Methods By retrospective analysis,29 cases of HPS were retrospectively analyzed as the study group,30 cases of non HPS children hospitalized for fever in the same period as the control group,and 28 cases of healthy children received physical examination in the same period as the healthy group.The levels of T lymphocyte subsets andγ-Interferon(IFN-γ),Interleukin-2(IL-2)and tumor necrosis factor-α(TNF-α)was compared among the three groups.Results The levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)T lymphocytes in the study group were higher than those in the control group and healthy group(t=1.781,2.957,2.844,P<0.05;t=3.328,9.380,9.443,P<0.05);The level of CD8^(+)was lower in the treatment than that in the control group and healthy group(t=-3.251,P<0.05;t=-4.752,P<0.05).The levels of IFN-γ,IL-2 and TNF-αwere higher in the study group than the control group(t=4.315,12.122,16.001,P<0.05);The study group was higher than the healthy group(t=8.328,21.956,21.028,P<0.05).The levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)and IFN-γ,IL-2,TNF-αin patients with good prognosis,the level of CD8^(+)was higher than that of the poor prognosis group(P<0.05).Conclusion The higher levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),IFN-γ,IL-2,TNF-αand the lower level of CD8^(+)were may indicate the HPS and poor prognosis.