静脉注射免疫球蛋白对川崎病患儿T淋巴细胞亚群水平的影响

Effect of Intravenous Immunoglobulin Injection on the Levels of T Lymphocyte Subsets in Children with Kawasaki Disease

【目的】探讨静脉注射免疫球蛋白对川崎病(KD)患儿治疗前后T淋巴细胞亚群水平的影响。【方法】选取2018年10月至2020年10月本院收治96例KD患儿,根据KD患儿发病3个月后冠状动脉损伤情况将其分为预后不良组和预后良好组。采用免疫散射比浊法检测KD患儿血清免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)水平,采用流式细胞仪检测外周血T淋巴细胞亚群水平,采用受试者工作特征(ROC)曲线分析T淋巴细胞亚群对KD患儿预后的预测价值。【结果】KD患儿治疗后血清IgG、IgA、IgM水平低于治疗前,差异有统计学意义(P<0.05)。KD患儿治疗后外周血CD3^(+)、CD3^(+)CD4^(+)、CD3^(+)CD8^(+)和CD4^(+)/CD8^(+)均低于治疗前(P<0.05)。KD患儿治疗后伴有冠状动脉损伤28例(29.17%),低于其治疗前的62例(64.58%),差异有统计学意义(P<0.001)。预后不良组CD3^(+)、CD3^(+)CD4^(+)、CD3^(+)CD8^(+)和CD4^(+)/CD8^(+)高于预后良好组(P<0.05)。CD3^(+)、CD3^(+)CD4^(+)、CD3^(+)CD8^(+)、CD4^(+)/CD8^(+)联合检测时的AUC高于其单独检测(P<0.05)。【结论】静脉注射免疫球蛋白治疗可以调节T淋巴细胞亚群水平,检测KD患儿体内T淋巴细胞亚群水平对KD患儿预后具有良好的预测价值。

【Objective】To investigate the effect of intravenous immunoglobulin injection on the levels of T lymphocyte subsets in children with kawasaki disease(KD)before and after treatment.【Methods】A total of 96 children with KD admitted to our hospital from October 2018 to October 2020 were selected and divided into a poor prognosis group and a good prognosis group based on their coronary artery injury three months after onset.The serum levels of immunoglobulin A(IgA),immunoglobulin G(IgG),and immunoglobulin M(IgM)were measured using immune scattering turbidimetry.The peripheral blood T lymphocyte subpopulations were measured using flow cytometry.The predictive value of T lymphocyte subpopulations on the prognosis of KD children was analyzed using receiver operating characteristic curve(ROC).【Results】The serum levels of IgG,IgA,and IgM in KD patients after treatment were lower than before treatment,with statistically significant differences(P<0.05).After treatment,the peripheral blood CD3^(+),CD3^(+)CD4^(+),CD3^(+)CD8^(+),and CD4^(+)/CD8^(+)levels in KD patients were lower than those before treatment(P<0.05).After treatment,there were 28 cases(29.17%)of KD patients with coronary artery injury,which was lower than those of the 62 cases(64.58%)before treatment,and the difference was statistically significant(P<0.001).The CD3^(+),CD3^(+)CD4^(+),CD3^(+)CD8^(+),and CD4^(+)/CD8^(+)levels in the poor prognosis group were higher than those in the good prognosis group(P<0.05).The AUC of CD3^(+),CD3^(+)CD4^(+),CD3^(+)CD8^(+)and CD4^(+)/CD8^(+)combined detection was higher than that of their individual detection(P<0.05).【Conclusion】Intravenous immunoglobulin therapy can regulate the level of T lymphocyte subsets,and detecting the level of T lymphocyte subsets in children with KD has good predictive value in evaluating the prognosis of KD.