婴幼儿常见下呼吸道感染性疾病与淋巴细胞亚群变化关系的研究

Changes in lymphocyte subsets in infants with common lower respiratory tract infectious diseases

摘要:

目的 探讨淋巴细胞亚群在儿童常见下呼吸道感染支气管炎、支气管肺炎和毛细支气管炎中的变化及临床意义。方法 选取111 例支气管炎、418 例支气管肺炎和83 例毛细支气管炎患儿为疾病组,同期健康婴幼儿235 例为对照组,用流式细胞仪检测各组淋巴细胞亚群。结果 支气管炎组总T 淋巴细胞、CD3⁺CD8⁺细胞低于对照组(P<0.05)。支气管肺炎组总T 淋巴细胞和CD3⁺CD8⁺ 细胞低于对照组、Th 和CD4/CD8 高于对照组,且Th 比例高于支气管炎组;与轻症肺炎组相比,重症肺炎组总T 淋巴细胞降低而B 淋巴细胞升高(P<0.05)。毛细支气管炎组Th 细胞和CD4/CD8 高于对照组、CD3⁺CD8⁺ 细胞低于对照组(P<0.01)。与对照组比,3 组下呼吸道感染患儿的B 淋巴细胞增高、NK 细胞比例降低(P<0.05)。结论 细胞免疫功能紊乱或低下以及体液免疫功能亢进参与了婴幼儿下呼吸道感染的发生和发展,并且变化程度与疾病类型及病情程度有关。

Abstract:

Objective To investigate the changes and clinical significance of lymphocyte subsets in infants with bronchitis, bronchopneumonia, and bronchiolitis. Methods A total of 111 children with bronchitis, 418 children with bronchopneumonia, and 83 children with bronchiolitis were enrolled as disease groups, and 235 healthy children were enrolled as control group. Flow cytometry was applied to measure lymphocyte subsets. Results The bronchitis group had significantly lower numbers of T cells and CD3⁺CD8⁺ T cells than the control group (P<0.05). The bronchopneumonia group had significantly lower numbers of T cells and CD3⁺CD8⁺ T cells, a significantly higher number of T helper (Th) cells, and a significantly higher CD4/CD8 ratio than the control group, as well as a significantly higher number of Th cells than the bronchitis group. Compared with the children with mild bronchopneumonia, those with severe bronchopneumonia showed a reduction in T cells and an increase in B cells (P<0.05). The bronchiolitis group had a significantly higher number of Th cells, a significantly higher CD4/CD8 ratio, and a significantly lower number of CD3⁺CD8⁺ T cells than the control group (P<0.01). The disease groups showed a significantly higher number of B cells and a significantly lower number of natural killer cells than the control group (P<0.05). Conclusions A low, disturbed cellular immune function and a high humoral immune function are involved in the development and progression of lower respiratory tract infectious diseases. The changes in immune function are related to the type and severity of diseases.