外周血淋巴细胞亚群与免疫球蛋白检测对传染性单核细胞增多症患儿的临床意义

Clinical significance of peripheral blood lymphocyte subsets and immunoglobulin detection in children with infectious mononucleosis

目的探讨外周血淋巴细胞亚群和血清免疫球蛋白检测对传染性单核细胞增多症(infectiousmononucleosis,IM)患儿的临床意义。方法选取2021年1月至2023年1月南通大学附属常州市儿童医院收治的41例EB病毒(epstein-Barr virus,EBV)感染引起的IM患儿作为病例组,并以同期来医院体检的41例健康儿童作为对照组。通过流式细胞术测定外周血淋巴细胞亚群水平、免疫散射比浊法检测血清免疫球蛋白含量、涂片检测其异型淋巴细胞的比例与阳性率,并比较两组异型淋巴细胞比例与阳性率及免疫球蛋白和淋巴细胞亚群含量。结果病例组血清免疫球蛋白IgA、IgM及IgG含量及外周血CD8^(+)T、CD3^(+)T、淋巴细胞数量、异型淋巴细胞的比例与阳性率均高于对照组,CD4^(+)/CD8^(+)T比值及B淋巴细胞数量低于对照组,差异均有统计学意义(P<0.05);两组CD4^(+)T和NK细胞数量比较差异无统计学意义。结论IM患儿无论体液免疫还是细胞免疫都有一定程度的功能失衡,因此,检测外周血淋巴细胞亚群以及血清免疫球蛋白含量,并辅以异型淋巴细胞涂片检查,可对及时掌握患儿病情变化并对疾病进行准确诊断提供一定的帮助。

Objective To explore the clinical significance of peripheral blood lymphocyte subsets and serum immunoglobulin detection in children with infectious mononucleosis(IM).Methods A total of 41 children with IM caused by epstein-Barr virus(EBV)infection admitted to Changzhou Children's Hospital Affiliated to Nantong University from January 2021 to January 2023 were taken as the case group,and 41 healthy children who came to the hospital for physical examination during the same period were taken as the control group.The level of peripheral blood lymphocyte subsets was determined by flow cytometry,serum immunoglobulin content detected by immune scattering turbidimetry,and smear detected the proportion and positive rate of their atypical lymphocytes.The proportion and positive rate of allotypic lymphocytes and the contents of immunoglobulin and lymphocyte subsets were compared between the two groups.Results Serum immunoglobulin IgA,IgM and IgG contents,peripheral blood CD8^(+)T,CD3^(+)T,number of lymphocytes,proportion and positive rate of allotypic lymphocytes in the case group were higher than those in the control group,and CD4^(+)/CD8^(+)T ratio and number of B lymphocytes were lower than those in the control group,and the differences were statistically significant(P<0.05);there were no significant differences in the number of CD4^(+)T and NK cells between the two groups.Conclusion Children with IM have a certain degree of functional imbalance in both humoral immunity and cellular immunity,therefore,the detection of peripheral blood lymphocyte subsets and serum immunoglobulin content,supplemented by atypical lymphocyte smear examination,can provide certain help for timely grasp the changes of children's condition and accurate diagnosis of the disease.