呼吸道合胞病毒与肺炎衣原体感染肺炎患儿的外周血淋巴细胞亚群特征比较

目的探讨呼吸道合胞病毒(RSV)与肺炎衣原体(CP)感染所致肺炎患儿的外周血淋巴细胞亚群特征。方法选取2020年1月至2020年12月桐庐县第一人民医院收治的单一病原体感染所致肺炎患儿1,000例,RSV感染496例,CP感染504例,分别作为RSV组、CP组,另选取同期在本院进行健康体检的儿童(性别、年龄相匹配)100例作为对照组。检测三组儿童的外周血淋巴细胞亚群,包括T淋巴细胞亚群、B淋巴细胞亚群、自然杀伤细胞百分比,测定比较三组的血清TGF-β1、IL-17、IFN-γ、IL-10水平。结果对照组的CD4^(+)/CD8^(+)绝对计数明显低于RSV组和CP组,差异有统计学意义(P<0.05)。RSV组的CD3^(+)CD4^(+)、CD4^(+)/CD8^(+)绝对计数均高于CP组,CD3-CD56/16+低于CP组,差异有统计学意义(P<0.05)。CP组的CD3^(+)CD4^(+)绝对计数与对照组接近(P>0.05),CD3-CD56/16+高于对照组,差异有统计学意义(P<0.05)。RSV和CP组的血清TGF-β1、IL-17、IFN-γ、IL-10水平高于对照组,差异有统计学意义(P<0.05)。RSV组与CP组的血清TGF-β1水平接近,差异无统计学意义(P>0.05)。RSV组的血清IL-17、IL-10水平比CP组更高,IFN-γ水平比CP组更低,差异有统计学意义(P<0.05)。RSV组和CP组急性感染患儿的血清TGF-β1、IL-17、IL-10、IFN-γ水平均比慢性感染患儿更高,差异有统计学意义(P<0.05)。结论RSV和CP感染引起的外周血淋巴细胞亚群变化有一定差异,二者分别主要通过调节IL-10和IFN-γ表达来影响CD4^(+)T细胞亚群,引起细胞免疫异常。

Objective To investigate the characteristics of peripheral blood lymphocyte subsets in children with pneumonia caused by respiratory syncytial virus(RSV)and chlamydia pneumoniae(CP).Methods 1,000 children with pneumonia caused by single pathogen infection,496 cases of RSV infection and 504 cases of CP infection treated in Tonglu First People's Hospital from January 2020 to December 2020 were selected as RSV group and CP group respectively,and 100 children(gender and age matched)who underwent physical examination in our hospital in the same period were selected as the control group.The peripheral blood lymphocyte subsets of these three groups,including T lymphocyte subsets,B lymphocyte subsets and the percentage of natural killer cells,were measured and compared-β1、IL-17、IFN-γ、IL-10 levels.Results The absolute counts of CD4^(+)/CD8^(+)in the control group were significantly lower than those in the RSV group and CP group,and the difference was statistically significant(P<0.05).The absolute counts of CD3^(+)CD4^(+),CD4^(+)/CD8^(+)in the RSV group were higher than those in the CP group,and the absolute counts of CD3-CD56/16+in the CP group were lower than those in the CP group(P<0.05),while CD3-CD56/16+was higher than that in the control group,and the difference was statistically significant(P<0.05).The level of TGF-β1,IL-17,IFN-γand IL-10 in RSV and CP groups were higher than those in the control group,and the difference was statistically significant(P<0.05).Serum TGF-β1 in RSV group and CP group were close,and there was no significant difference(P>0.05).The serum levels of IL-17 and IL-10 in RSV group were higher than those in CP group,and the IFN-γlevel was lower than that in CP Group,and the difference was statistically significant(P<0.05).In RSV group and CP Group,the serum levels of TGF-β1,IL-17,IL-10 and IFN-γin children with acute infection were higher than those in children with chronic infection,and the difference was statistically significant(P<0.05).Conclusion There are some differences in the changes of peripheral blood lymphocyte subsets caused by RSV and CP infection,and they affect the CD4^(+)T cell subsets mainly by regulating the expression of IL-10 and IFN-γrespectively,which leads to abnormal cellular immunity.