云南地区反复输血的地中海贫血儿童细胞免疫和体液免疫状态的研究

Cellular and humoral immune status of thalassemia children with repeated blood transfusion in Yunnan province

目的了解云南反复输血的地中海贫血儿童细胞免疫(外周血淋巴细胞亚群)和体液免疫(血清免疫球蛋白及铁蛋白)状态水平的变化。方法选取2020年1月—2022年10月期间本院反复输血的地中海贫血儿童46例,为观察组;未输血的地中海贫血儿童40例,为对照1组;健康体检儿童46例,为对照2组;比较3组儿童淋巴细胞亚群、血清免疫球蛋白及铁蛋白浓度之间的差异。结果淋巴细胞亚群:观察组低于对照1组和2组,CD3+分别为57.60±8.36、64.57±7.56、66.58±5.65,CD4+分别为33.16±5.67、38.62±8.36、38.62±6.41,CD4+/CD8+分别为1.49±0.09、2.32±0.15、2.13±0.16。观察组低于对照2组:CD16+CD56+分别为11.21±5.06、16.70±7.92,观察组高于对照1组和2组:CD8+分别为26.63±1.75、20.60±1.43、18.92±0.84,观察组高于对照2组:CD19+分别为24.06±6.42、19.67±8.42,P<0.05;两对照组之间,P>0.05。血清免疫球蛋白、铁蛋白:观察组高于对照1组和2组:IgG分别为10.59±3.88、7.02±3.88、5.58±1.98,铁蛋白分别为:2037.37±1377.59、72.63±56.71、59.48±33.88,观察组高于对照2组:IgA分别为1.06±0.92、0.39±0.32,P<0.05;两对照组之间,P>0.05;IgM、IgE 3组间比较,P>0.05。结论反复输血的地中海贫血儿童淋巴细胞亚群比例失调,体液免疫中免疫球蛋白水平异常。

Objective To investigate the changes in cellular immunity(peripheral blood lymphocyte subsets)and hu⁃moral immunity(serum immunoglobulin and ferritin)status among children with thalassemia who received repeated transfu⁃sions in Yunnan.Methods Forty⁃six children with thalassemia who underwent repeated blood transfusions from January 2020 to October 2022 were selected as the observation group.Forty children with thalassemia who did not receive blood trans⁃fusion were included in control group 1,and 46 healthy children underwent physical examination were included in control group 2.The differences in lymphocyte subsets,serum immunoglobulin levels and ferritin concentrations were compared a⁃mong the three groups.Results For lymphocyte subsets:CD3+,CD4+and CD4+/CD8+in the observation group was lower than the control group 1 and 2:57.60±8.36 vs 64.57±7.56 vs 66.58±5.65,33.16±5.67 vs 38.62±8.36 vs 38.62±6.41 and 1.49±0.09 vs 2.32±0.15 vs 2.13±0.16,respectively;CD16+CD56+in the observation group was lower than the control group 2:11.21±5.06 vs 16.70±7.92;CD8+in the observation group was higher than control group 1 and control group 2:26.63±1.75 vs 20.60±1.43 vs 18.92±0.84;CD19+in the observation group was higher than the control group 2:24.06±6.42 vs 19.67±8.42,P<0.05,but no significant difference was noticed between the two control groups(P>0.05).For serum immunoglobu⁃lin and ferritin:IgG and ferritin in the observation group were higher than control group 1 and control group 2:10.59±3.88 vs 7.02±3.88 vs 5.58±1.98 and 2037.37±1377.59 vs 72.63±56.71 vs 59.48±33.88.IgA in the observation group was higher than the control group 2:1.06±0.92 vs 0.39±0.32(P<0.05),but no significant difference was noticed between the two con⁃trol groups(P>0.05).The difference of IgM and IgE between the three groups was not significant(P>0.05).Conclusion The proportion of lymphocyte subsets in thalassemia children with re⁃peated blood transfusion was imbalanced,and the level of immu⁃noglobulin in humoral immunity was abnormal.