淋巴细胞亚群测定在儿童传染性单核细胞增多症病情评估中的应用研究

Study on the application of lymphocyte subpopulation in the evaluation of infectious mononucleosis in children

目的探究淋巴细胞亚群测定在儿童传染性单核细胞增多症(IM)病情评估中的应用价值。方法选择2019年1月至2022年6月江西省九江市妇幼保健院住院部收治的传染性单核细胞增多症患儿90例为研究对象,依据患儿的血液内异型淋巴细胞数值分成观察组(40例,异型淋巴细胞值<10%)、对照组(50例,异型淋巴细胞值≥10%)。采集两组患儿血液,经荧光聚合酶链反应法测定血液内异型淋巴细胞比值,并经流式细胞仪测定T淋巴细胞亚群指标(CD4^(+)及CD8^(+)、CD4^(+)/CD8^(+))的水平。比较两组IM患儿的T淋巴细胞亚群指标水平,并记录两组IM患儿病情恢复时间(退热时间、肝脾淋巴结肿大回缩时间)。经Spearman相关性分析法对IM患儿(异型淋巴细胞比值≥10%)的T淋巴细胞亚群指标水平和病情恢复时间之间相关性进行分析。结果观察组IM患儿的CD8^(+)值低于对照组,但CD4^(+)、CD4^(+)/CD8^(+)值均高于对照组,差异有统计学意义(P<0.05)。观察组IM患儿的退热时间、肝脾淋巴结肿大回缩时间均短于对照组,差异有统计学意义(P<0.05)。通过Spearman相关性分析法分析发现,异型淋巴细胞比值≥10%的IM患儿CD4^(+)、CD4^(+)/CD8^(+)值与退热时间、肝脾淋巴结肿大回缩时间之间均呈负相关(P<0.05),而CD8^(+)值与退热时间、肝脾淋巴结肿大回缩时间之间均呈正相关(P<0.05)。结论淋巴细胞亚群测定在儿童IM病情评估中发挥着重要作用,监测T淋巴细胞亚群指标值的变化,能为临床预测IM发生和病情提供一定依据,是判定IM患儿免疫功能的敏感性及特异性指标。

Objective To explore the application value of lymphocyte subpopulation assay in the evaluation of infectious mononucleosis(IM)in children.Methods A total of 90 children with infectious mononucleosis admitted to the inpatient department of Jiangxi Jiujiang Maternal and Child Health Hospital from January 2019 to June 2022 were selected as the study subjects,and they were divided into the observation group(40 cases,heterotypic lymphocyte value<10%)and the control group(50 cases,heterotypic lymphocyte value≥10%)according to the blood heterotypic lymphocyte value of the children.The blood of the two groups of children was collected,and the ratio of heterotypic lymphocytes in the blood was measured by fluorescence polymerase chain reaction,and the level of T lymphocyte subsets(CD4^(+),CD8^(+),CD4^(+)/CD8^(+))was measured by flow cytometry.The levels of T lymphocyte subsets in the two groups of children with IM were compared,and the recovery time of the two groups of children with IM was recorded(time of fever abatement,time of swelling and retraction of lymph nodes of liver and spleen).Spearman correlation analysis was used to analyze the correlation between the level of T lymphocyte subsets and the recovery time of IM children(heterotypic lymphocyte ratio≥10%).Results The CD8^(+)value of IM children in the observation group was lower than that in the control group,but the CD4^(+)and CD4^(+)/CD8^(+)values were higher than those in the control group,with statistically significant differences(P<0.05).The antipyretic time and the swelling and retraction time of liver and spleen lymph nodes in the observation group were shorter than those in the control group,with statistically significant differences(P<0.05).Through Spearman correlation analysis,it was found that the CD4^(+)and CD4^(+)/CD8^(+)values of IM children with allotypic lymphocyte ratio≥10%were negatively correlated with the time of fever regression and the time of swelling and retraction of liver and spleen lymph nodes(P<0.05),while the CD8^(+)values were positively correlated with the time of fever regression and the time of swelling and retraction of liver and spleen lymph nodes(P<0.05).Conclusion The determination of lymphocyte subsets plays an important role in the evaluation of children's IM condition.Monitoring the changes of T lymphocyte subsets can provide a certain basis for clinical prediction of the occurrence and condition of IM,and is a sensitive and specific indicator for judging the immune function of children with IM.