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目的:探讨肺炎支原体肺炎(MPP)患儿外周血CD4n -CD8n -双阴性T淋巴细胞(DNT)、T淋巴细胞亚群、自然杀伤(NK)细胞、CDn 19+B淋巴细胞的变化及临床意义。n 方法:回顾性分析2019年1月至2020年2月上海交通大学附属儿童医院收治的肺炎患儿，年龄段划分为0～3岁、4～7岁、≥8岁，急性期接受外周血T淋巴细胞亚群检测，其中185例MPP患儿为观察组，根据病情分为117例MPP普通组和68例MPP重症组，另外选取69例非MPP肺炎患儿作为对照组。采用流式细胞术分析各组患儿外周血DNT、T淋巴细胞亚群、NK细胞、CDn 19+B淋巴细胞绝对计数。分析不同年龄段DNT水平。n 结果:1.观察组外周血淋巴细胞CD3n +[1.527(1.059，2.348)×10n 9/L]、CD4n +[0.771(0.559，1.206)×10n 9/L]、CD8n +[0.528(0.343，0.773)×10n 9/L]、CD4n +/CD8n +[1.570(1.130，1.945)]、CDn 19+ [0.455(0.285，0.771)×10n 9/L]、DNT[0.168(0.095，0.294)×10n 9/L]均低于对照组[2.116(1.506，3.728)×10n 9/L、1.170(0.685，2.114)×10n 9/L、0.696(0.414，1.226)×10n 9/L、1.780(1.230，2.210)、0.694(0.483，1.343)×10n 9/L、0.235(0.134，0.391)×10n 9/L]，差异均有统计学意义(均n P<0.05)。2.MPP普通组的外周血淋巴细胞CD3n +[1.704(1.215，2.566)×10n 9/L]、CD4n +[0.855(0.628，1.267)×10n 9/L]、CD8n +[0.582(0.378，0.843)×10n 9/L]、NK[0.269(0.176，0.417)×10n 9/L]、CDn 19+[0.461(0.317，0.808)×10n 9/L]、DNT[0.180(0.117，0.306)×10n 9/L]均明显高于MPP重症组[1.369(0.831，1.760)×10n 9/L、0.676(0.433，0.924)×10n 9/L、0.495(0.292，0.699)×10n 9/L、0.196(0.112，0.380)×10n 9/L、0.391(0.181，0.730)×10n 9/L、0.143(0.071，0.265)×10n 9/L]，差异均有统计学意义(均n P0.05)；观察组中，0～3岁组外周血DNT[0.230(0.125，0.364)×10n 9/L]高于4～7岁组[0.143(0.085，0.233)×10n 9/L]和≥8岁组[0.144(0.078，0.271)×10n 9/L]，且在0～3岁组病情越重，指标越低，差异均有统计学意义(均n P<0.05)。n 结论:急性期，MPP患儿外周血各淋巴细胞亚群变化显著。外周血DNT淋巴细胞绝对计数降低，且病情越重，指标越低。小年龄患儿DNT绝对计数较高。监测外周血DNT对评估MPP免疫功能状态或病情可能有一定价值。“,”Objective:To discuss the changes and clinical significance of CD4n -CD8n -double negative T lymphocytes (DNT), T lymphocyte subsets, natural killer (NK) cells and CDn 19+ B lymphocytes in peripheral blood of children with confirmed Mycoplasma pneumoniae pneumonia(MPP).n Methods:A retrospective analysis was conducted on children with pneumonia admitted to the Children′s Hospital of Shanghai Jiaotong University from January 2019 to February 2020.The patients were stratified into 3 age groups: 0-3 years old, 4-7 years old and ≥8 years old, and they received detection of peripheral blood T lymphocyte subsets in acute stage.As observation group, 185 MPP children were further divided into MPP common group (117 cases) and MPP severe group (68 cases) based on their state of pneumonia.In addition, 69 cases with non-MPP were selected as control group.The absolute counts of DNT, T lymphocyte subsets, NK cells and CDn 19+ B lymphocytes in peripheral blood were tested by flow cytometry.DNT levels in diffe-rent age groups were analyzed.n Results:(1) The number of CD3n + [1.527(1.059, 2.348)×10n 9/L], CD4n + [0.771(0.559, 1.206)×10n 9/L], CD8n + [0.528(0.343, 0.773)×10n 9/L], CD4n + /CD8n + [1.570(1.130, 1.945)], CDn 19+ [0.455(0.285, 0.771)×10n 9/L] and DNT[0.168(0.095, 0.294)×10n 9/L] lymphocytes in peripheral blood in the observation group were lower than those in the control group[2.116(1.506, 3.728)×10n 9/L, 1.170(0.685, 2.114)×10n 9/L, 0.696(0.414, 1.226)×10n 9/L, 1.780(1.230, 2.210), 0.694(0.483, 1.343)×10n 9/L, 0.235(0.134, 0.391)×10n 9/L], and the differences were statistically significant (all n P<0.05). (2) In addition, the number of CD3n + [1.704(1.215, 2.566)×10n 9/L], CD4n + [0.855(0.628, 1.267)×10n 9/L], CD8n + [0.582(0.378, 0.843)×10n 9/L], NK[0.269(0.176, 0.417)×10n 9/L], CDn 19+ [0.461(0.317, 0.808)×10n 9/L] and DNT[0.180(0.117, 0.306)×10n 9/L]lymphocytes in peripheral blood in MPP common group were significantly higher than those in MPP severe group [1.369(0.831, 1.760)×10n 9/L, 0.676(0.433, 0.924)×10n 9/L, 0.495(0.292, 0.699)×10n 9/L, 0.196(0.112, 0.380)×10n 9/L, 0.391(0.181, 0.730)×10n 9/L, 0.143(0.071, 0.265)×10n 9/L], and the differences were statistically significant (all n P0.05). In the observation group, the number of DNT[0.230(0.125, 0.364)×10n 9/L] in 0-3 years old group was higher than that in 4-7 years old group[0.143(0.085, 0.233)×10n 9/L] and ≥ 8 years old group[0.144(0.078, 0.271)×10n 9/L]. In 0-3 years old group, the more serious the disease, the lower the indicators, and the differences were statistically significant (all n P<0.05).n Conclusions:In acute phase, the changes of lymphocyte subsets in peripheral blood of MPP children are remarkable, and the absolute count of DNT lymphocytes in peripheral blood decreased.The decreasing level of DNT has negative association with the severity of pneumonia.The absolute count of DNT was higher in young children.So monitoring peripheral blood DNT may be of some value to the assessment of immune function or pneumonia state in children with MPP.