病毒性脑炎患儿脑脊液中Acrp30表达与T淋巴细胞亚群的关系

The relationship between Acrp30 expression and T lymphocyte subsets in cerebrospinal fluid of children with viral encephalitis

目的探讨病毒性脑炎(VE)患儿脑脊液脂联素(Acrp30)水平与T淋巴细胞亚群的关系。方法选取2016年5月-2019年6月本院诊治的98例VE患儿为VE组,另选取同期45例无神经系统疾病但需进行外科手术的腰麻儿童为对照组。酶联免疫吸附法(ELISA)检测脑脊液Acrp30水平;流式细胞仪测定CD3^(+)、CD8^(+)、CD4^(+)水平,计算CD4^(+)/CD8^(+);依据VE患儿病情严重程度将其分为重度组(30例)、中度组(36例)、轻度组(32例),比较不同严重程度的VE患儿脑脊液Acrp30水平、T淋巴细胞亚群水平;Pearson法分析VE患儿脑脊液Acrp30水平与T淋巴细胞亚群的关系;比较不同预后的VE患儿脑脊液Acrp30水平、T淋巴细胞亚群水平。结果VE组患儿脑脊液Acrp30、CD8^(+)[(10.97±3.66)ng/L、(38.91±3.57)%]水平高于对照组[(3.43±1.14)ng/L、(33.05±3.03)%](t=13.499、9.541,均P<0.05),CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)[(54.73±5.59)%、(39.35±4.02)%、(1.01±0.17)]水平低于对照组[(63.81±6.42)%、(51.54±5.20)%、(1.56±0.26)](t=8.602、15.308、15.088,均P<0.05);重度组VE患儿脑脊液Acrp30、CD8^(+)[(13.52±4.51)ng/L、(42.84±3.93)%]水平高于轻度组[(8.38±2.79)ng/L、(35.01±3.21)%]、中度组[(11.15±3.72)ng/L、(39.10±3.59)%](F=14.837、37.089,P<0.05),CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)[(51.80±5.22)%、(36.51±3.73)%、(0.81±0.14)]水平低于轻度组[(57.66±5.80)%、(42.23±4.31)%、(1.21±0.20)]、中度组[(54.57±5.51)%、(39.16±4.05)%、(1.00±0.16)](F=8.746、15.555、43.622,P<0.05);中度组患儿VE患儿脑脊液Acrp30、CD8^(+)[(11.15±3.72)ng/L、(39.10±3.59)%]水平高于轻度组[(8.38±2.79)ng/L、(35.01±3.21)%](P<0.05),CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)[(54.57±5.51)%、(39.16±4.05)%、(1.00±0.16)]水平低于轻度组[(57.66±5.80)%、(42.23±4.31)%、(1.21±0.20)](P<0.05);VE患儿脑脊液Acrp30水平与CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)呈负相关(P<0.05),与CD8^(+)呈正相关(P<0.05);后遗症组VE患儿脑脊液Acrp30、CD8^(+)[(16.62±5.90)ng/L、(42.32±3.88)%]水平高于无后遗症组[(9.43±3.18)ng/L、(37.98±3.48)%](t=7.477、4.942,P<0.05),CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)[(49.93±5.08)%、(36.53±3.74)%、(0.83±0.14)]水平低于无后遗症组[(56.04±5.70)%、(40.12±4.11)%、(1.06±0.18)](t=4.451、3.613、5.418,P<0.05)。结论VE患儿脑脊液Acrp30水平较高,与T淋巴细胞亚群CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)等显著相关,Acrp30、CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)等可作为临床评估VE患儿病情严重程度及预后的辅助指标。

Objective To investigate the relationship between the level of adiponectin(Acrp30)and T lymphocyte subsets in cerebrospinal fluid of children with viral encephalitis(VE).Methods Ninety-eight children with VE who were diagnosed and treated in our hospital from May 2016 to June 2019 were selected as the VE group.In the same period,45 children without neurological disease requiring spinal anesthesia surgery were selected as the control group.Enzyme-linked immunosorbent assay(ELISA)was used to detect Acrp30 level in cerebrospinal fluid;flow cytometry was used to measure CD3^(+),CD8^(+),CD4^(+)levels,and calculate CD4^(+)/CD8^(+);according to the severity of VE children,they were divided into severe group(30 cases),moderate group(36 cases)and mild group(32 cases).The levels of Acrp30 and T lymphocyte subtypes in cerebrospinal fluid of children with VE of different severity were compared,Pearson method was used to analyze the relationship between Acrp30 level and T lymphocyte subsets in cerebrospinal fluid of children with VE;the levels of Acrp30 and T lymphocyte subsets in cerebrospinal fluid of children with VE with different prognosis were compared.Results The levels in Acrp30 and CD8^(+)[(10.97±3.66)ng/L,(38.91±3.57)%]in the cerebrospinal fluid of children in the VE group were higher than those in the control group[(3.43±1.14)ng/L,(33.05±3.03)%](t=13.499,9.541,P<0.05),and the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)[(54.73±5.59)%,(39.35±4.02)%,(1.01±0.17)]were lower than those in the control group[(63.81±6.42)%,(51.54±5.20)%,(1.56±0.26)](t=8.602,15.308,15.088,P<0.05);the levels of Acrp30 and CD8^(+)[(13.52±4.51)ng/L,(42.84±3.93)%]in cerebrospinal fluid of children with severe VE were higher than those in the mild group[(8.38±2.79)ng/L,(35.01±3.21)%]and moderate group[(11.15±3.72)ng/L,(39.10±3.59)%](F=14.837,37.089,P<0.05),and the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)[(51.80±5.22)%,(36.51±3.73)%,(0.81±0.14)]were lower than those in the mild group[(8.38±2.79)ng/L,(35.01±3.21)%]and moderate group[(54.57±5.51)%,(39.16±4.05)%,(1.00±0.16)](F=8.746,15.555,43.622,P<0.05);the levels of Acrp30 and CD8^(+)[(11.15±3.72)ng/L,(39.10±3.59)%]in cerebrospinal fluid of children with VE in the moderate group were higher than those in the mild group[(8.38±2.79)ng/L,(35.01±3.21)%](P<0.05),and the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)[(54.57±5.51)%,(39.16±4.05)%,(1.00±0.16)]were lower than those in the mild group[(57.66±5.80)%,(42.23±4.31)%,(1.21±0.20)(P<0.05);the level of Acrp30 in cerebrospinal fluid in children with VE was negatively correlated with CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)(r=-0.454,-0.531,-0.428,P<0.05),and positively correlated with CD8^(+)(r=0.497,P<0.05);the levels of Acrp30 and CD8^(+)[(16.62±5.90)ng/L,(42.32±3.88)%]in cerebrospinal fluid in the sequela group were higher than those in the non-sequela group[(9.43±3.18)ng/L,(37.98±3.48)%](t=7.477,4.942,P<0.05),and the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)[(49.93±5.08)%,(36.53±3.74)%,(0.83±0.14)]were lower than those in the non-sequela group[(56.04±5.70)%,(40.12±4.11)%,(1.06±0.18)](t=4.451,3.613,5.418,P<0.05).Conclusion The level of Acrp30 in the cerebrospinal fluid of children with VE is relatively high,which is significantly related to T lymphocyte subsets CD4^(+),CD3^(+),CD4^(+)/CD8^(+),CD8^(+),etc.Acrp30,CD4^(+),CD3^(+),CD4^(+)/CD8^(+),CD8^(+),etc.can be used as auxiliary indexes for clinical evaluation of the severity and prognosis of children with VE.