支气管肺炎患儿免疫功能变化的临床分析

Clinical analysis of immune function changes in children with bronchial pneumonia

摘要:

目的：通过检测普通和重症支气管肺炎患儿血清补体、免疫球蛋白、淋巴细胞亚群变化，探讨免疫功能检测在支气管肺炎中可能的作用。方法：纳入符合诊断标准的普通和重症支气管肺炎患儿各20例，同时选取健康儿童20例为对照组。采用免疫速率散射比浊法和六色流式细胞仪分析法检测各组儿童血清IgA、IgG、IgM、补体C3、C4及淋巴细胞亚群CD3+、CD4+、CD8+、CD16+CD56+及CD19+指标变化。结果：普通及重症肺炎组IgA水平均较对照组明显降低（P<0.05）；重症肺炎患儿IgG水平较对照组降低（P<0.05）；两组肺炎患儿IgM、补体C3、C4水平与对照组比较差异均无统计学意义（P>0.05）；重症肺炎组CD4+、CD3+水平均较对照组降低（P<0.05），而CD19+水平高于对照组（P＜0.05），CD16+CD56+水平低于对照组及普通肺炎组（均P<0.05）；两组肺炎患儿CD8+水平及CD4+/CD8+比值与对照组比较差异均无统计学意义（P>0.05）。结论：支气管肺炎患儿存在免疫功能的紊乱，在重症组更为明显，免疫水平的变化与肺炎病情的严重程度相关。支气管肺炎患儿免疫功能检测具有重要的临床意义。

Abstract:

OBJECTIVE: To investigate changes in serum complement, immunoglobulins and lymphocyte subsets in children with common and severe bronchial pneumonia, and the role of immune function testing in bronchial pneumonia. METHODS: Twenty children with common bronchial pneumonia, 20 with severe bronchial pneumonia and 20 healthy children (as controls) were enrolled in this study. Immunization rate scattering turbidimetry and six-color flow cytometry were used to detect changes in serum levels of IgA, IgG and IgM, complement C3 and C4 and CD3+, CD4+, CD8+, CD16+, CD56+ and CD19+ cells. RESULTS: The IgA levels of children with common and severe pneumonia were significantly lower than in the control group (P<0.05). The IgG level of children with severe pneumonia was significantly lower than in the control group (P<0.05). There were no significant differences in the levels of IgM and complement C3 and C4 between the two pneumonia groups and the control group (P>0.05). Compared with the controls, the children with severe pneumonia showed significantly lower CD4+ and CD3+ counts (P<0.05) and a significantly higher CD19+ count (P<0.05), and the CD16+ and CD56+ counts of children with severe pneumonia were significantly lower than in the controls and in children with common pneumonia (P<0.05). There were no differences in CD8+ count and CD4+/CD8+ ratio between the two pneumonia groups and the control group (P>0.05). CONCLUSIONS: Immune dysfunction exists in children with bronchial pneumonia, especially those with severe pneumonia. Changes in immune function are correlated with the severity of pneumonia. Immune function testing in children with pneumonia has important clinical significance.