中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2008年
6期
549-552
,共4页
病毒感染%肺炎%免疫功能
病毒感染%肺炎%免疫功能
병독감염%폐염%면역공능
Viral infection%Pneumonia%Immune function
目的 探讨病毒性肺炎患儿自然杀伤(NK)细胞亚群、T细胞亚群及血IL-2、IL-4、INF-γ的动态变化及临床意义.方法 采用流式细胞术测定32例病毒性肺炎患儿急性期(肺炎起病2?d内)、恢复期(肺炎起病5?d内)外周血NK细胞亚群、T细胞亚群,用ELISA法测定血IL-2、IL-4、INF-γ水平,用乳酸脱氢酶释放法测定NK细胞活性变化,并与30例健康对照组儿童进行比较.结果 (1) 病毒性肺炎患儿CD16+CD56+、CD16+NK细胞在急性期分别为(0.73±0.17)%、(0.39±0.2)%,恢复期分别为(1.47±0.22)%、(0.89±0.14)%;急性期与恢复期比较,恢复期CD16+CD56+、CD16+NK细胞明显升高(P<0.01),但均显著低于对照组(P<0.01).两组NK细胞亚群变化与其活性改变呈正相关.病毒性肺炎患儿CD56+NK细胞与健康儿童差异无显著性(P>0.05).(2) 与对照组相比,病毒性肺炎患儿的急性期、恢复期IL-2、IL-4均无明显改变,差异无显著性(P>0.05);急性期INF-γ无明显改变,差异无显著性(P>0.05),而恢复期INF-γ[(28.10±1.38)?μg/L]明显高于急性期[(22.78±1.19)?μg/L],差异有非常显著性(P<0.01).(3) 与对照组相比,病毒性肺炎患儿CD4+、CD4+/CD8+T细胞计数在急性期与恢复期均无明显改变,差异无显著性(P>0.05).病毒性肺炎急性期、恢复期CD8+T细胞均低于对照组,差异有显著性(P<0.05),但病毒性肺炎急性期、恢复期间差异无显著性(P>0.05).结论 病毒性肺炎患儿NK细胞活性降低,活性与亚群数目呈正相关;病毒性肺炎患儿抑制性T细胞功能低下.病毒性肺炎急性期NK细胞激活是多因素共同作用的结果 .
目的 探討病毒性肺炎患兒自然殺傷(NK)細胞亞群、T細胞亞群及血IL-2、IL-4、INF-γ的動態變化及臨床意義.方法 採用流式細胞術測定32例病毒性肺炎患兒急性期(肺炎起病2?d內)、恢複期(肺炎起病5?d內)外週血NK細胞亞群、T細胞亞群,用ELISA法測定血IL-2、IL-4、INF-γ水平,用乳痠脫氫酶釋放法測定NK細胞活性變化,併與30例健康對照組兒童進行比較.結果 (1) 病毒性肺炎患兒CD16+CD56+、CD16+NK細胞在急性期分彆為(0.73±0.17)%、(0.39±0.2)%,恢複期分彆為(1.47±0.22)%、(0.89±0.14)%;急性期與恢複期比較,恢複期CD16+CD56+、CD16+NK細胞明顯升高(P<0.01),但均顯著低于對照組(P<0.01).兩組NK細胞亞群變化與其活性改變呈正相關.病毒性肺炎患兒CD56+NK細胞與健康兒童差異無顯著性(P>0.05).(2) 與對照組相比,病毒性肺炎患兒的急性期、恢複期IL-2、IL-4均無明顯改變,差異無顯著性(P>0.05);急性期INF-γ無明顯改變,差異無顯著性(P>0.05),而恢複期INF-γ[(28.10±1.38)?μg/L]明顯高于急性期[(22.78±1.19)?μg/L],差異有非常顯著性(P<0.01).(3) 與對照組相比,病毒性肺炎患兒CD4+、CD4+/CD8+T細胞計數在急性期與恢複期均無明顯改變,差異無顯著性(P>0.05).病毒性肺炎急性期、恢複期CD8+T細胞均低于對照組,差異有顯著性(P<0.05),但病毒性肺炎急性期、恢複期間差異無顯著性(P>0.05).結論 病毒性肺炎患兒NK細胞活性降低,活性與亞群數目呈正相關;病毒性肺炎患兒抑製性T細胞功能低下.病毒性肺炎急性期NK細胞激活是多因素共同作用的結果 .
목적 탐토병독성폐염환인자연살상(NK)세포아군、T세포아군급혈IL-2、IL-4、INF-γ적동태변화급림상의의.방법 채용류식세포술측정32례병독성폐염환인급성기(폐염기병2?d내)、회복기(폐염기병5?d내)외주혈NK세포아군、T세포아군,용ELISA법측정혈IL-2、IL-4、INF-γ수평,용유산탈경매석방법측정NK세포활성변화,병여30례건강대조조인동진행비교.결과 (1) 병독성폐염환인CD16+CD56+、CD16+NK세포재급성기분별위(0.73±0.17)%、(0.39±0.2)%,회복기분별위(1.47±0.22)%、(0.89±0.14)%;급성기여회복기비교,회복기CD16+CD56+、CD16+NK세포명현승고(P<0.01),단균현저저우대조조(P<0.01).량조NK세포아군변화여기활성개변정정상관.병독성폐염환인CD56+NK세포여건강인동차이무현저성(P>0.05).(2) 여대조조상비,병독성폐염환인적급성기、회복기IL-2、IL-4균무명현개변,차이무현저성(P>0.05);급성기INF-γ무명현개변,차이무현저성(P>0.05),이회복기INF-γ[(28.10±1.38)?μg/L]명현고우급성기[(22.78±1.19)?μg/L],차이유비상현저성(P<0.01).(3) 여대조조상비,병독성폐염환인CD4+、CD4+/CD8+T세포계수재급성기여회복기균무명현개변,차이무현저성(P>0.05).병독성폐염급성기、회복기CD8+T세포균저우대조조,차이유현저성(P<0.05),단병독성폐염급성기、회복기간차이무현저성(P>0.05).결론 병독성폐염환인NK세포활성강저,활성여아군수목정정상관;병독성폐염환인억제성T세포공능저하.병독성폐염급성기NK세포격활시다인소공동작용적결과 .
Objective To observe the changes of NK cell subset (CD56+,CD16+CD56+,CD16+),T cell subset (CD4+,CD8+,CD4+/CD8+) counts and related cytokines (IL-2,IL-4,INF-γ) in children with viral pneumonia.Methods Thirty-two children with viral pneumonia in acute stage (within 2 days after pneumonia onset) and recovery phase (within the range of the third to the fifth day after pneumonia onset) were included in this study.Peripheral blood NK cell subsets and T cell substes were determined by the flow cytometry.Blood IL-2,IL-4 and INF-γ were detected by ELISA.NK cytoactivity was measured by LDH release method.Results (1) The levels of the CD16+CD56+ and CD16+NK cell counting in acute stage [(0.73±0.17)% and (0.39±0.20)%] were lower than those in the recovery phase [(1.47±0.22)% and (0.89±0.14)%],which showed significant difference (P<0.01),however the level of CD16+CD56+ and CD16+NK cell counting either in acute stage or recovery phase was significantly lower than those of healthy control group (P<0.01).The sub population counting and NK cell activity was directly correlated.CD56+NK cell counting showed no significant difference between viral pneumonia group and control group (P>0.05).(2) There was no significant difference in blood IL-2 and IL-4 level between viral pneumonia group (either in acute stage or recovery phase) and the control group (P>0.05).As compared with that of the control group,blood INF-γ level of viral pneumonia group showed no significant change in acute stage (P>0.05),but INF-γ level in recovery phase [(28.10±1.38)?μg/L] was higher than that in acute stage [(22.78±1.19)?μg/L] and there was significant difference (P<0.01).(3) As compared with that of the control group,CD4+ and CD4+/CD8+T cell counting of viral pneumonia group showed no obvious changes either in acute stage or recovery phase (P>0.05).CD8+T cell counting of both two stages were much lower than that of the control group (P<0.05),but there was no significant difference between the two stages (P>0.05).Conclusion The NK cell activity in children with viral pneumonia decline obviously,which might be related to the changes of T cell subsets;the activity of suppressor T cell was depressed in patients with viral pneumonia.There are maybe many factors involved in the NK cell activation.
