大肠埃希菌脑膜炎患儿炎性因子及细胞免疫特征

Inflammatory factors and cellular immune characteristics in children with Escherichia coli meningitis

目的探讨大肠埃希菌脑膜炎患儿炎性因子及细胞免疫特征。方法选取2018年1月-2022年1月邢台市人民医院就诊的大肠埃希菌脑膜炎患儿100例为研究组,另选择50名健康体检儿童作为健康组,检测两组研究对象外周血和研究组脑脊液炎症因子表达水平,检测研究组脑脊液CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)、外周T辅助细胞(Tph)活化水平。结果研究组脑脊液中C-反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)、IL-1β、肿瘤坏死因子-α(TNF-α)、γ干扰素(IFN-γ)高于外周血中以上指标,且高于健康组(P<0.05);研究组外周血、脑脊液中的CD_(3)^(+)(%)、CD_(4)^(+)(%)、CD_(4)^(+)/CD_(8)^(+)低于健康组,CD_(8)^(+)(%)高于健康组;研究组外周血、脑脊液中的Tph活化水平高于健康组(P<0.05),且Tph的活化标志分子MHCⅡ+Tph亚群、ICOS+Tph亚群的比例高于健康组,同时研究组脑脊液中的MHCⅡ+Tph亚群、ICOS+Tph亚群比例高于研究组外周血。结论大肠埃希菌刺激后,T淋巴细胞活化表型异于健康儿童,且在炎症部位异常活化,释放大量炎性因子。

OBJECTIVE To investigate the inflammatory factors and cellular immune characteristics in children with Escherichia coli meningitis.METHODS Totally 100 children with Escherichia coli meningitis who were admitted to the Xingtai People's Hospital from Jan.2018 to Jan.2022 were selected as the study group,and another 50 children with healthy physical examination were selected as the healthy group.The levels of inflammatory factors in the peripheral blood of the two groups and the cerebrospinal fluid of the study group were tested,and the levels of CD_(3)^(+),CD_(4)^(+),CD_(8)^(+),and peripheral T helper cells(Tph)activation in the cerebrospinal fluid of the study group were detected.RESULTS The CRP,PCT,IL-6,IL-1β,TNF-α,and IFN-γin the cerebrospinal fluid of the study group were higher than the above indicators in the peripheral blood and higher than in the healthy group(P<0.05);the CD_(3)^(+)(%),CD_(4)^(+)(%),CD_(4)^(+)/CD_(8)^(+)in the peripheral blood and cerebrospinal fluid of the study group were lower than in the healthy group,while CD_(8)^(+)(%)was higher than in the healthy group;the Tph activation level in the peripheral blood and cerebrospinal fluid of the study group was higher than that in the healthy group(P<0.05),and the proportion of molecular MHCⅡ+Tph subgroups and ICOS+Tph subgroups,the activation mark of Tph,was higher than that of the healthy group,while the proportion of MHCⅡ+Tph subgroups and ICOS+Tph subgroups in the cerebrospinal fluid of the study group was higher than that of the peripheral blood.CONCLUSION After stimulation by Escherichia coli,the activation phenotype of T lymphocytes was different from that of healthy children,and it was abnormally activated at the site of inflammation,releasing a large number of inflammatory factors.