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目的探讨巨细胞病毒感染致肝炎患儿外周血T淋巴细胞的表达和意义。方法选取2010年6月-2012年10月在该院确诊治疗的巨细胞病毒感染致肝炎的患儿70例为肝炎组,依据巨细胞病毒载量水平分为高载量组、中载量组和低载量组;同期选取体检中心健康儿童10例为健康组,统计分析巨细胞病毒感染致肝炎患儿外周血T淋巴细胞亚群表达水平,应用Spearman分析法分析T淋巴细胞亚群与巨细胞病毒载量水平的关系。结果肝炎组患儿外周血中CD3、CD4、CD4/CD8水平明显低于健康组,差异有统计学意义(P<0.05),CD8水平两组差异无统计学意义(P>0.05)。高载量组患儿外周血中CD3、CD4、CD4/CD8水平明显低于中载量组,中载量组患儿外周血中CD3、CD4、CD4/CD8水平明显低于低载量组,差异均有统计学意义(均P<0.05),3者CD8水平差异无统计学意义(P>0.05)。Spearman分析法结果显示,巨细胞病毒与CD3、CD4百分率和CD4/CD8比值呈现负相关(r1=-0.563,P=0.003;r2=-0.502,P=0.006;r4=-0.751,P<0.001),与CD8百分率无关(r3=0.073,P=0.472)。结论巨细胞病毒引起的肝炎患儿感染后使机体免疫功能受到抑制,病情越严重免疫功能越低下,巨细胞病毒主要抑制T淋巴细胞亚群中CD3、CD4淋巴细胞增殖,对CD8无明显影响。临床检测患儿T淋巴细胞亚群中CD3、CD4水平有助于医师进行早期诊断与治疗,值得推广。
Objective To investigate the expression and significance of T lymphocytes in children with hepatitis caused by cytomegalovirus infection. Methods Seventy patients with hepatitis caused by cytomegalovirus diagnosed and treated in our hospital from June 2010 to October 2012 were selected as hepatitis group. According to cytomegalovirus load level, 70 cases were divided into high load group, medium load group And low-load group. In the same period, 10 healthy children were selected as healthy group. The expression of T-lymphocyte subsets in peripheral blood of children with cytomegalovirus infection was statistically analyzed by Spearman analysis. Relationship between viral load levels of cells. Results The levels of CD3, CD4 and CD4 / CD8 in peripheral blood of children with hepatitis were significantly lower than those of healthy controls (P <0.05). There was no significant difference in CD8 between the two groups (P> 0.05). The levels of CD3, CD4 and CD4 / CD8 in peripheral blood of high-load group were significantly lower than those of medium-load group, and the levels of CD3, CD4 and CD4 / CD8 in middle-load group were significantly lower than those in low-load group (All P <0.05). There was no significant difference in CD8 between the three groups (P> 0.05). Spearman analysis showed cytomegalovirus negatively correlated with CD3, CD4 percentage and CD4 / CD8 ratio (r1 = -0.563, P = 0.003; r2 = -0.502, P = 0.006; r4 = -0.751, P <0.001) , Independent of the percentage of CD8 (r3 = 0.073, P = 0.472). Conclusion Cytomegalovirus induced hepatitis in children with suppressed immune function, the more serious the disease under the lower immune function, cytomegalovirus mainly in T lymphocyte subsets in CD3, CD4 lymphocyte proliferation, no significant effect on CD8. Clinical detection of T lymphocyte subsets in children CD3, CD4 levels help physicians for early diagnosis and treatment, it is worth promoting.