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目的探讨不同病期感染传染性单核细胞增多症(IM)患儿T淋巴细胞亚群、B淋巴细胞、自然杀伤细胞(NK细胞)及免疫球蛋白的变化。方法应用流式细胞术、免疫散射比浊法检测22例IM患儿急性期及恢复期血T淋巴细胞亚群CD3、CD4、CD8及B淋巴细胞CD19、NK细胞CD56的表达及IgG、IgA、IgM水平,并与25例健康儿童(健康对照组)作比较。结果 IM患儿急性期血CD3、CD4、CD8、CD19、CD56分别为(78.71±11.83)%、(18.36±6.06)%、(36.19±8.23)%、(8.15±6.41)%、(18.19±7.61)%,健康对照组分别为(60.03±10.22)%、(39.53±8.16)%、(21.55±5.96)%、(19.83±8.49)%、(16.19±6.13)%,急性期CD3、CD8与健康对照组比较均显著性升高(Pa<0.01),CD4、CD19与健康对照组比较均明显降低(Pa<0.01),CD56与健康对照组比较无明显差异(P>0.05)。IM患儿恢复期CD3、CD4、CD8、CD19、CD56分别为(64.29±10.67)%、(32.14±7.25)%、(25.47±6.07)%、(14.29±7.37)%、(16.75±6.74)%,与健康对照组比较差异均无统计学意义(Pa>0.05)。IM患儿急性期血IgG、IgA、IgM分别为(17.50±3.92)g·L-1、(1.55±0.36)g·L-1、(1.27±0.53)g·L-1,健康对照组分别为(7.91±2.82)g·L-1、(0.92±0.28)g·L-1、(1.09±0.33)g·L-1,IgG、IgA与健康对照组比较均明显偏高(P<0.01,0.05),IgM与健康对照组比较无明显差异(P>0.05);IM患儿恢复期血IgG、IgA、IgM分别为(11.30±3.07)g·L-1、(1.14±0.31)g·L-1、(1.20±0.35)g·L-1,IgG仍高于健康对照组(P<0.05),IgA、IgM与健康对照组比较差异均无统计学意义(Pa>0.05)。结论 IM患儿存在细胞免疫和体液免疫失调,检测IM患儿免疫功能水平有利于判断治疗效果,为临床应用免疫调节剂提供理论依据。
Objective To investigate the changes of T lymphocyte subsets, B lymphocytes, natural killer cells (NK cells) and immunoglobulins in children with infectious mononucleosis (IM) at different stages. Methods The expressions of CD56, CD4, CD8 and CD56 in CD19 and NK cells of 22 T lymphocyte subsets in 22 IM patients were detected by flow cytometry and immunostaining turbidimetry. IgM levels and compared with 25 healthy children (healthy control group). Results The percentages of CD3, CD4, CD8, CD19 and CD56 in the acute stage of IM children were (78.71 ± 11.83)%, (18.36 ± 6.06)%, (36.19 ± 8.23)%, (8.15 ± 6.41)% and ) And healthy controls were (60.03 ± 10.22)%, (39.53 ± 8.16)%, (21.55 ± 5.96)%, (19.83 ± 8.49)% and (16.19 ± 6.13)%, respectively (P <0.01). The levels of CD4 and CD19 in the control group were significantly lower than those in the healthy control group (Pa0.01). There was no significant difference between the control group and the healthy control group (P> 0.05). The recovery rates of CD3, CD4, CD8, CD19 and CD56 in IM children were (64.29 ± 10.67)%, (32.14 ± 7.25)%, (25.47 ± 6.07)%, (14.29 ± 7.37)% and (16.75 ± 6.74)%, , No significant difference compared with the healthy control group (Pa> 0.05). The levels of IgG, IgA and IgM in the acute phase of IM children were (17.50 ± 3.92) g · L -1, (1.55 ± 0.36) g · L -1, (1.27 ± 0.53) g · L -1, respectively (7.91 ± 2.82) g · L-1, (0.92 ± 0.28) g · L-1 and (1.09 ± 0.33) g · L-1, respectively. (P <0.05). The levels of IgG, IgA and IgM in the recovery stage of IM patients were (11.30 ± 3.07) g · L -1, (1.14 ± 0.31) g · L-1, (1.20 ± 0.35) g · L-1, IgG were still higher than those in healthy controls (P <0.05). There was no significant difference between IgA and IgM in healthy controls (P> 0.05). Conclusion There is cellular and humoral immune disorders in children with IM, and the detection of immune function in children with IM is helpful to judge the therapeutic effect and provide a theoretical basis for the clinical application of immunomodulators.