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EB病毒感染儿童血淋巴细胞亚群变化的意义 被引量:21

Changes of Lymphocyte Subsets in Children with Epstein-Barr Virus Infection
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摘要 目的研究EB病毒(EBV)感染儿童血淋巴细胞亚群的变化规律,探讨淋巴细胞亚群与抗EBV衣壳抗原IgM抗体(EBV-VCA-IgM)滴度是否有相关性。方法选取147例EBV感染儿童为观察组,排除EBV等疱疹病毒科感染儿童48例为对照组。将观察组根据不同感染形式[单纯EBV感染、传染性单核细胞增多症(IM)]及不同年龄(<3岁,≥3岁)分别分组。应用流式细胞仪对外周血单个核细胞表面CD3+、CD8+、CD4+、CD56+、CD19+抗原进行检测,并计算CD4+/CD8+比例,分别与对照组比较。同时检测EBV-VCA-IgM滴度,分析其与各种细胞亚群是否具有相关性。结果 1.单纯EBV感染组CD4+、CD56+下降,CD19+升高。IM组改变更为显著,CD8+明显高于对照组和单纯EBV感染组,CD4+、CD56+明显下降,低于其他二组,CD4+/CD8+比例明显倒置,CD19+明显下降。2.<3岁组CD3+、CD4+低于对照组,CD19+明显上升,显著高于对照组和≥3岁组,CD8+、CD56+与对照组比较则无统计学差异。≥3岁组改变较明显,CD3+、CD8+明显高于对照组和<3岁组,CD4+、CD56+下降,低于其他二组,CD4+/CD8+比例倒置,CD19+低于<3岁组。3.CD8+与EBV-VCA-IgM滴度呈显著正相关,CD4+、CD4+/CD8+、CD19+与EBV-VCA-IgM均呈显著负相关,而CD56+与EBV-VCA-IgM滴度无相关性。4.IM组中2例临床症状好转后,CD3+、CD8+下降,CD4+、CD19+上升。结论相对于年龄小、单纯EBV感染的患儿,年龄大、IM儿童淋巴细胞亚群改变更明显。淋巴细胞亚群与EBV-VCA-IgM滴度存在显著相关性,临床可根据EBV-VCA-IgM滴度预测患儿细胞免疫功能紊乱程度。 Objective To study the changes of lymphocyte subsets in children with Epstein-Barr virus(EBV) infection,and explore whether there is any correlation between lymphocyte subsets and anti-EBV-viral capsid antigen(VCA)-IgM titer.Methods One hundred and forty-seven cases of EBV-infection children were selected as observation group,and 48 cases of excluding herpes virus such as EBV-infected children were selected as control group.According to the different forms and different ages,the 147 cases of EBV-VCA-IgM positive infection children were divided into 4 groups:simple EBV infection group,infectious mononucleosis(IM) group,3 years old group and ≥3 years old group.The antigen on the surface of peripheral blood mononuclear cells including CD3^+,CD8^+,CD4^+,CD56^+,CD19^+ were analyzed by flow cytometry,and compared with those in control group.At the same time,EBV-VCA-IgM titer was detected and the correlation between the titer and cell subsets was analyzed.Results 1.In simple EBV infection group,CD4^+,CD56^+ decreased while CD19^+ increased.Significant changes were found in IM group:CD8^+ in IM group was higher than that in control group and simple EBV infection group,but CD4^+,CD56^+ decreased obviously,which were lower than those in the other 2 groups,and ratio of CD4^+/ CD8^+ inverted as CD19^+ decreased significantly.2.In 3 years old group,CD3^+,CD4^+ were less than those in the control group,while CD19^+ increased more than that in the control group and ≥3 years old group,there was no statistical difference in CD8^+ and CD56^+.Compared with the control group,≥ 3 years old group had the obvious changes,as CD3^+,CD8^+ were significantly higher than those in the control group and 3 years old group,CD4^+ and CD56^+,which were lower obviously than the other 2 groups,ratio of CD4^+/CD8^+ inverted.CD19^+ was only lower than 3 years old group.3.CD8^+ and EBV-VCA-IgM titers were positively correlated,as CD4^+,CD4^+/CD8^+ and CD19^+ showed significantly negative correlation,while CD56^+ and EBV-VCA-IgM titers had no correlation.4.After the clinical symptoms improved,2 cases of IM group reviewed the indicators,which could be found CD3^+,CD8^+ decreased,while CD4^+,CD19^+ increased.Conclusions Compared with the younger and merely EBV infected children,the lymphocyte subsets changed more obviously in the older age,IM children.There was significant correlation between lymphocyte subsets and EBV-VCA-IgM titer,which can predict the degree of cellular immune dysfunction.
出处 《实用儿科临床杂志》 CAS CSCD 北大核心 2010年第10期733-735,共3页 Journal of Applied Clinical Pediatrics
关键词 EB病毒 淋巴细胞亚群 抗EB病毒衣壳抗原IgM抗体 儿童 Epstein-Barr virus lymphocyte subsets Epstein-Barr virus-viral capsid antigen-immunoglobulin M child
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