传染性单核细胞增多症患儿淋巴细胞亚群、免疫球蛋白水平变化及与过敏性疾病的关系

Changes of lymphocyte subsets and immunoglobulin levels in children with infectious mononucleosis and their relationship with allergic diseases

目的分析传染性单核细胞增多症(IM)患儿淋巴细胞亚群、免疫球蛋白水平变化及与过敏性疾病的关系。方法选取2018年6月—2022年6月期间就诊的IM患儿114例,根据是否伴有过敏性疾病分为IM过敏组和非过敏组,同期体检的正常儿童50名为对照组,比较CD3+、CD4+及CD8+T细胞、Treg及Th17细胞,IgE、IgA、IgM和IgG水平。结果IM非过敏组和过敏组分别为73例、41例。与对照组相比,IM非过敏组和过敏组的CD3+、CD8+T细胞及Th17细胞比例升高,而Treg细胞、Treg/Th17比值下降,差异均有统计学意义(P<0.05);与IM非过敏组相比,对照组、IM过敏组的CD4+T细胞比较升高,差异有统计学意义(P<0.05);与IM非过敏组相比,过敏组的CD3+、CD8+T细胞比例升高,而Treg细胞、Treg/Th17比值下降,差异均有统计学意义(P<0.05)。与对照组比,IM非过敏组和过敏组的IgE、IgA、IgM和IgG水平升高,差异均有统计学意义(P<0.05);与IM非过敏组相比,过敏组的IgE、IgA、IgM和IgG水平升高,差异均有统计学意义(P<0.05)。IM过敏组的IgE水平与CD3+、CD4+、CD8+、Th17、IgA、IgM及IgG呈显著性正相关。结论过敏性疾病与IM患儿的发生和预后可能存在一定的关系,IgE水平可作为IM临床症状早期严重程度的参考指标.

Objective To analyze the changes of serum lymphocyte subsets and immunoglobulin levels in children with infectious mononucleosis(IM),and their relationship with allergic diseases. Methods A total of 114 children with IM from June 2018 to June 2022 were selected. According to whether they ere accompanied with allergic diseases,they were divided into IM allergic group and IM non-allergic group,and 50 children took physi cal examination in the same period were selected as control group. The levels of CD3+,CD4+,CD8+ T cells,Treg,Th17cells and IgE,Ig A,Ig M and IgG in each group were compared. Results There were 73 cases in non-allergic group and 41 cases in allergic group. Compared with the control group,the proportion of CD3+,CD8+ T cells and Th17cells in IM non-allergic group and allergic group increased,while Treg cells and Treg/Th17 ratio decreased,and the differences were statistically significant(P<0.05). Compared with IM non-allergic group,the CD4^( +) T cells in the control group and IM allergic group were significantly higher(P<0.05). Compared with non-IM allergic group,the proportion of CD3+ and CD8+ T cells in IM allergic group increased,while Treg cells and Treg/Th17 ratio decreased,and the differences were statistically significant(P<0.05). Compared with the control group,the levels of IgE,IgA,IgM and IgG in IM non-allergic group and allergic group were higher,and the differences were statistically significant(P<0.05). Compared with non-allergic IM group,the levels of IgE,IgA,IgM and IgG in allergic IM group were significantly higher(P<0.05). Correlation analysis showed that IgE levels in IM allergic group were positively correlated with CD3+,CD4+,CD8+,Th17,IgA,IgM and IgG. Conclusion Allergic diseases may be related to the incidence and prognosis of IM children,and IgE level could be used as a reference index for the early severity of clinical symptoms of IM.