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目的探讨重症肺炎链球菌感染患儿淋巴细胞亚群与血清免疫球蛋白及IgG亚类水平的变化。方法收集2009年1月-2010年1月在首都儿科研究所呼吸科住院的27例重症肺炎链球菌肺炎婴幼儿为病例组,65例健康儿童为健康对照组。分别采用流式细胞仪与散射比浊法测定二组儿童细胞免疫(C;;DOI:10.3969/j.issn.3+、C;;DOI:10.3969/j.issn.3+C;;DOI:10.3969/j.issn.4+、C;;DOI:10.3969/j.issn.3+C;;DOI:10.3969/j.issn.8+、C;;DOI:10.3969/j.issn.4+/C;;DOI:10.3969/j.issn.8+、C;;DOI:10.3969/j.issn.19+、NK细胞)与体液免疫(IgG、IgA、IgM)及IgG亚类(IgG1、IgG2、IgG3、IgG4)水平。结果 1.与健康对照组比较,病例组患儿外周血C;;DOI:10.3969/j.issn.3+C;;DOI:10.3969/j.issn.4+数量降低(t=0.000,P<0.05),C;;DOI:10.3969/j.issn.3+C;;DOI:10.3969/j.issn.8+(t=0.000,P<0.05)、C;;DOI:10.3969/j.issn.4+/C;;DOI:10.3969/j.issn.8+(t=0.013,P<0.05)、IgA(t=0.004,P<0.05)、IgM(t=0.000,P<0.05)、IgG2(t=0.018,P<0.05)显著升高。2.病例组患儿中检出IgG亚类缺陷11例(占40.74%),以IgG2、IgG4缺陷为主。3.与健康对照组比较,11例IgG亚类缺陷患儿C;;DOI:10.3969/j.issn.3+C;;DOI:10.3969/j.issn.4+(t=0.006,P<0.05)、C;;DOI:10.3969/j.issn.4+/C;;DOI:10.3969/j.issn.8+(t=0.015,P<0.05)均显著降低,C;;DOI:10.3969/j.issn.3+C;;DOI:10.3969/j.issn.8+(t=0.013,P<0.05)、NK细胞计数(t=0.045,P<0.05)均显著升高。结论重症肺炎链球菌感染患儿存在细胞免疫和体液免疫紊乱以及IgG亚类缺陷。
Objective To investigate the changes of lymphocyte subsets, serum immunoglobulins and IgG subclasses in children with severe pneumococcal infection. Methods 27 cases of severe pneumococcal pneumonia infants and young children hospitalized in Respiratory Department of Capital Institute of Pediatrics from January 2009 to January 2010 were collected as case group and 65 healthy children as healthy control group. The cellular immunity of two groups of children was measured by flow cytometry and nephelometry respectively. (C DOI: 10.3969 / j.issn.3+, C DOI: 10.3969 / j.issn.3 + C DOI: DOI: 10.3969 / j.issn.3 + C; DOI: 10.3969 / j.issn.8+, C; DOI: 10.3969 / j.issn.4 + / C DOI: C, DOI: 10.3969 / j.issn.8 +, C; DOI: 10.3969 / j.issn.19 + NK cells) and humoral immunity (IgG, IgA and IgM) and IgG subclasses (IgG1, IgG2, IgG3, IgG4) levels. Compared with the healthy control group, the number of peripheral blood in the case group was significantly lower (t = 0.000, P < DOI: 10.3969 / j.issn.3 + C; DOI: 10.3969 / j.issn.8 + (t = 0.000, P <0.05), C DOI: 10.3969 / j.issn 4 + / C; DOI: 10.3969 / j.issn.8 + (t = 0.013, P <0.05) t = 0.018, P <0.05). In the case group, 11 IgG subclass defects (40.74%) were detected in the children with IgG2 and IgG4 defects. Compared with the healthy control group, 11 cases of IgG subclass deficient children C ;; DOI: 10.3969 / j.issn.3 + C ;; DOI: 10.3969 / j.issn.4 + (t = 0.006, P <0.05 ), C ;; DOI: 10.3969 / j.issn.4 + / C ;; DOI: 10.3969 / j.issn.8 + (t = 0.015, .issn.3 + C ;; DOI: 10.3969 / j.issn.8 + (t = 0.013, P <0.05). NK cell count (t = 0.045, P <0.05) increased significantly. Conclusion There are cellular and humoral immune disorders and IgG subclass deficiencies in children with severe pneumococcal infection.