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目的:观察脾氨肽干预对传染性单核细胞增多症(IM)患儿T细胞亚群的影响,探讨其对IM患儿的免疫调节作用。方法:选取2011年6月至2014年5月在我院住院的IM患儿102例,分为常规治疗组52例和脾氨肽干预组50例。两组患儿均给予对症处理,同时给予更昔洛韦每次5 mg/kg,每12 h一次静脉滴注,治疗1周;脾氨肽干预组加用口服脾氨肽冻干粉每次2 mg,每天一次,连服10 d。以我院同期健康体检儿童26例作为正常对照组,观察常规治疗组和脾氨肽干预组患儿外周血T细胞亚群的变化情况。结果:治疗前两组患儿CD4+、CD16+CD56+、CD4+/CD8+均低于正常对照组(P<0.01),CD3+、CD8+均高于正常对照组(P<0.01);治疗后两组患儿T细胞亚群异常情况均有所恢复,且脾氨肽干预组CD4+、CD4+/CD8+上升幅度及CD3+、CD8+下降幅度均大于常规治疗组(P<0.05),而CD16+CD56+与常规治疗组比较差异无统计学意义(P>0.05)。结论:IM患儿存在T淋巴细胞免疫功能低下,脾氨肽干预可促进IM患儿细胞免疫功能恢复。
Objective: To observe the effect of splenic aminopeptidase on T lymphocyte subsets in children with infectious mononucleosis (IM) and to explore its immunoregulatory effect on children with IM. Methods: A total of 102 children with IM who were admitted to our hospital from June 2011 to May 2014 were divided into routine treatment group (n = 52) and spleen ammonia peptide intervention group (n = 50). Two groups of children were given symptomatic treatment, while given ganciclovir each 5 mg / kg, once every 12 h intravenous infusion for 1 week; spleen ammonia peptide intervention group plus oral splenic ammonia peptide lyophilized powder each time 2 mg once daily for 10 days. Twenty-six healthy children in our hospital were taken as normal control group, and the changes of T lymphocyte subsets in peripheral blood of routine treatment group and spleen-ammonia-peptide intervention group were observed. Results: The levels of CD4 +, CD16 + CD56 + and CD4 + / CD8 + of the two groups before treatment were lower than those of the normal control group (P <0.01), and the levels of CD3 + and CD8 + were higher than those of the normal control group T cell subsets abnormalities recovered, and the increase of CD4 +, CD4 + / CD8 + and the decrease of CD3 +, CD8 + of splenomegaly peptide intervention group were more than those of conventional treatment group (P <0.05), while CD16 + CD56 + The difference was not statistically significant (P> 0.05). Conclusion: The immune function of T lymphocytes in children with IM is low. Spleen ammonia peptide intervention can promote the recovery of cellular immune function in children with IM.