静脉滴注免疫球蛋白对川崎病患儿细胞免疫功能的影响

Effect of intravenous immunologlobulin on cell-mediated immunity in children with Kawasaki disease

目的 探讨静脉滴注免疫球蛋白 (IVIG)对川崎病患儿细胞免疫 (红细胞免疫及T细胞亚群 )功能的影响及其预防冠状动脉损害的作用机理。方法 T细胞亚群采用S P一步法 ,红细胞免疫活性及其调节因子测定用刘景田法。测定 37例川崎病患儿急性期及恢复期细胞免疫功能的变化。结果 川崎病患儿急性期红细胞C3b受体花环率 (RBC·C3bRR)下降 ,免疫复合物花环率 (ICRR)升高 ,促进因子 (E)活性降低 ,抑制因子 (I)升高 ,E/I降低 ,CD3、CD4下降 ,CD8升高 ,CD4 /CD8下降 ,与对照组比较有显著差异 (P <0 .0 1 )。经IVIG治疗后RBC·C3bR、促进因子 (E)回升 ,ICRR抑制因子 (I)下降 ,CD3、CD4回升 ,CD8下降 ,CD4 /CD8回升 ,临床症状明显改善。结论 细胞免疫功能改变参与了川崎病的发病 ,IVIG可能与提供抗体抑制免疫反应 ,减少血管炎症反应有关 。

Objective To investigate the effect of intravenous immunologlobulin(IVIG) on cell mediated immunity(erythrocytic immunity and T lymphocyte immunity) in the children with Kawasaki disease(KD),and its mechanism of preventing coronary artery lesion.Methods The function of erythrocytic immunity and its mediating factor was evaluated by Liujingtian method and T lymphocyte subsets were measured by S P methods in 37 patients with KD during the acute and recovery periods.Results During the acute period of infection,the round rate of RBC·C3b(RBC·C3bRR) was decreased but the round rate of immunocomplex(ICRR) was increased.RFER was lowered but RFIR was increased and E/I was lowered.CD3 and CD4 were lowered but CD8 was increased and CD4/CD8 was decreased,compared with control group,with significant difference(P<0.01).After IVIG therapy,RBC·C3bR and RFER were increased but ICRR was decreased.CD3 and CD4 were increased but CD8 was decreased and CD4/CD8 was increased.Clinical symptom was significantly improved.Conclusion The changes of the function of cell mediated immunity are involved in the Kawasaki disease.IVIG might provide antibodies to control the immunity reaction and reduce the blood vessel inflammation,therefore,IVIG can improve KD inflammation of acute period and prevent the coronary artery lesion.