流感病毒感染与川崎病发病的关系及患儿外周血细胞因子和T淋巴细胞水平变化

Analysis of the correlation between influenza virus infection and Kawasaki disease and the variation levels of peripheral blood cytokines and T lymphocytes in children

目的分析流感病毒感染与川崎病发病的关系及患儿外周血细胞因子、T淋巴细胞水平变化。方法将2018年10月-2023年3月衡水市人民医院收治的川崎病合并流感病毒感染者32例纳入合并组,川崎病98例纳入川崎病组,流感病毒感染患儿102例纳入流感病毒感染组,回顾性收集患儿临床资料。对比合并组、川崎病组临床表现,合并组、流感病毒感染组病毒类型,三组实验室指标、外周血细胞因子、T淋巴细胞水平。结果相较川崎病组,合并组肛门皮肤脱皮、冠脉损害、注射丙种球蛋白无反应情况占比高,发热持续时间更长(P<0.05);与流感病毒感染组比较,合并组副流感病毒3型占比更低,腺病毒占比更高(P<0.05);合并组全血血小板数(PLT)、CD_(8)^(+)水平、血清白细胞介素-2(IL-2)、C-反应蛋白(CRP)、降钙素原(PCT)水平高于川崎病组、流感病毒感染组(P<0.05);合并组血清丙氨酸转氨酶(ALT)、淀粉样蛋白酶A(SAA)水平高于流感病毒感染组、川崎病组,流感病毒感染组血清ALT、SAA水平高于川崎病组(P<0.05);合并组全血CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平低于川崎病组、流感病毒感染组(P<0.05)。结论川崎病合并流感病毒感染患儿病毒类型与流感病毒感染患儿存在差异,合并流感病毒感染可加重临床表现,川崎病的发生可能与流感病毒引起的外周血细胞因子及T淋巴细胞紊乱有关,可作为临床诊治的依据。

OBJECTIVE To investigate the correlation between influenza virus infection and Kawasaki disease,and analyze the variation levels of peripheral blood cytokines and T lymphocytes in children.METHODS Clinical data of children admitted to the People's Hospital in Hengshui City from Oct 2018 to Mar 2023 were retrospective ana-lyzed in the study.32 cases of Kawasaki disease infected with influenza virus included in the combination group,98 cases of Kawasaki disease were included in the Kawasaki disease group,and 102 cases of children infected with in-fluenza virus were included in the influenza virus infection group.Clinical manifestations between the combined group and the Kawasaki disease group,virus types between the combined group and influenza virus infection group,levels of laboratory indexes,peripheral blood cytokines and T lymphocyte among the three groups were compared.RESULTS Compared with the Kawasaki disease group,the incidence of anal skin peeling,coronary ar-tery damage and non-response to injection of gamma globulin were higher in the combined group,and the duration of fever was longer(P<0.05).Compared with the influenza virus infection group,the proportion of parainfluenza virus type 3 was lower while the proportion of adenovirus was higher in the combined group(P<0.05).The lev-els of whole blood platelet count(PLT),CD_(8)^(+),serum interleukin-2(IL-2),C-reactive protein(CRP)and pro-calcitonin(PCT)in the combined group were higher than those in the Kawasaki disease group and the influenza vi-rus infection group(P<0.05).The levels of alanine aminotransferase(ALT)and amyloid protease A(SAA)in the combination group were higher than those in the influenza virus infection group and the Kawasaki disease group;the levels of ALT and SAA in the influenza virus infection group were higher than those in the Kawasaki disease group(P<0.05).The levels of whole blood of CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)in the combined group were lower than those in the Kawasaki disease group and the influenza virus infection group(P<0.05).CONCLUSION The virus types in children with Kawasaki disease complicated with influenza were different from those in children only infected with influenza virus.Co-infection with influenza virus could aggravate Kawasaki disease's clinical manifes-tations,and the occurrence of the disease may be related to the disturbance of peripheral blood cytokines and T lymphocytes caused by influenza virus,which could be used as the basis for clinical diagnosis and treatment.