CAJ | 학술논문

目的：探讨婴儿痉挛症患儿免疫功能变化及促肾上腺皮质激素（ ACTH）对淋巴细胞亚群的影响。方法2012年11月至2014年9月济宁医学院附属医院儿科初次确诊的25例婴儿痉挛症患儿作为病例组，21例健康儿童为对照组。病例组给予ACTH治疗4周，治疗前及治疗4周后分别检测其外周血CD3＋T淋巴细胞、CD4＋T淋巴细胞、CD8＋T淋巴细胞和CD4＋／CD8＋值，并与对照组进行比较。结果病例组CD3＋T淋巴细胞为（64．2±7．5）％，低于对照组[（70．2±8．4）％]，差异有统计学意义（ t ＝2．53， P＜0．05）；病例组CD4＋T淋巴细胞为（38．7±4．8）％，低于对照组[（46．8±5．7）％]，差异有统计学意义（ t ＝5．15， P ＜0．05）；病例组 CD8＋T 淋巴细胞为（35．6±5．7）％，对照组为（34．4±4．9）％，差异无统计学意义（ t ＝0．77， P＞0．05）；病例组CD4＋／CD8＋值为1．4±0．3，对照组为1．7±0．5，差异有统计学意义（ t ＝2．41， P ＜0．05）；病例组CD3＋T淋巴细胞治疗前为（64．2±7．5）％，治疗后为（64．9±8．6）％，差异无统计学意义（ t ＝0．32， P ＞0．05）；病例组 CD4＋T 淋巴细胞治疗前为（38．7±4．8）％，治疗后为（39．2±4．6）％，差异无统计学意义（ t ＝0．41， P＞0．05）；病例组CD8＋T淋巴细胞治疗前为（35．6±5．7）％，治疗后为（35．9±5．9）％，差异无统计学意义（ t ＝0．21， P＞0．05）；病例组CD4＋／CD8＋值治疗前为1．4±0．3，治疗后为1．5±0．5，差异无统计学意义（ t ＝0．80， P＞0．05）。结论婴儿痉挛症患儿存在免疫功能紊乱，ACTH对其淋巴细胞亚群无影响，未影响患儿细胞免疫功能。
목적：탐토영인경련증환인면역공능변화급촉신상선피질격소（ ACTH）대림파세포아군적영향。방법2012년11월지2014년9월제저의학원부속의원인과초차학진적25례영인경련증환인작위병례조，21례건강인동위대조조。병례조급여ACTH치료4주，치료전급치료4주후분별검측기외주혈CD3＋T림파세포、CD4＋T림파세포、CD8＋T림파세포화CD4＋／CD8＋치，병여대조조진행비교。결과병례조CD3＋T림파세포위（64．2±7．5）％，저우대조조[（70．2±8．4）％]，차이유통계학의의（ t ＝2．53， P＜0．05）；병례조CD4＋T림파세포위（38．7±4．8）％，저우대조조[（46．8±5．7）％]，차이유통계학의의（ t ＝5．15， P ＜0．05）；병례조 CD8＋T 림파세포위（35．6±5．7）％，대조조위（34．4±4．9）％，차이무통계학의의（ t ＝0．77， P＞0．05）；병례조CD4＋／CD8＋치위1．4±0．3，대조조위1．7±0．5，차이유통계학의의（ t ＝2．41， P ＜0．05）；병례조CD3＋T림파세포치료전위（64．2±7．5）％，치료후위（64．9±8．6）％，차이무통계학의의（ t ＝0．32， P ＞0．05）；병례조 CD4＋T 림파세포치료전위（38．7±4．8）％，치료후위（39．2±4．6）％，차이무통계학의의（ t ＝0．41， P＞0．05）；병례조CD8＋T림파세포치료전위（35．6±5．7）％，치료후위（35．9±5．9）％，차이무통계학의의（ t ＝0．21， P＞0．05）；병례조CD4＋／CD8＋치치료전위1．4±0．3，치료후위1．5±0．5，차이무통계학의의（ t ＝0．80， P＞0．05）。결론영인경련증환인존재면역공능문란，ACTH대기림파세포아군무영향，미영향환인세포면역공능。
Objective To explore the change of immune function and the effect of Adrenocorticotropic hormone ( ACTH) on lymphocyte subsets in children with infantile spasm. Methods Twenty?five cases with newly diagnosed infantile spasm were gathered from November 2012 to September 2014, while another twenty?one healthy cases were chosen as normal control group.ACTH was administered for 4 weeks.Sera was sampled for analyses of the counts of CD3+,CD4+ and CD8+ before and after 4 weeks of treatment,and the results were compared with those of the controls.Results Compared to the controls,the count of CD3+T cell in patients demonstrated significant decreasement [patients:(64.2±7.5)%,controls:(70.2±8.4)%, t =2.53%, P<0.05].The count of CD4+T cell in patients demonstrated significant reduction [patients:(38.7± 4.8)%,controls:(46.8±5.7)%, t =5.15, P<0.05].The count of CD8+T cell had no statistically significant differences between patients and controls [patients:(35.6±5.7)%,controls:(34.4±4.9)%, t=0.77, P>0.05].The ratio of CD4+/CD8+T cell in patients demonstrated significant decrease [ patients:1. 4 ± 0. 3, controls:1.7±0.5, t =2.41, P<0.05].The count of CD3+T cell in patients had no statistically significant differences before and after treatment [before treatment:(64.2±7.5)%,after treatment:(64.9±8.6)%, t =0.32, P>0.05].The count of CD4+T cell in patients had no statistically significant differences before and after treatment [before treatment:(38.7±4.8)%,after treatment:(39.2±4.6)%, t =0.41, P>0.05].The count of CD8+T cell in patients had no statistically significant differences before and after treatment ( before treatment:(35.6±5.7)%,after treatment:(35.9±5.9)%, t =0.21, P>0.05).The ratio of CD4+/CD8+T cell in patients had no statistically significant differences before and after treatment (before treatment:1.4±0.3, after treatment:1.5±0.5, t=0.80, P>0.05).Conclusions Children with infantile spasm have immunological alterations,and ACTH has no effect on lymphocyte subsets. ACTH may not regulate the cellular immune function of children with infantile spasm.