摘要
目的探讨T细胞亚群选择性缺失及体液免疫受损在脓毒症发生、发展中的作用。方法依据小儿危重病例评分法,将106例脓毒症患儿(脓毒症组)分为非危重组(>80分)、危重组(80～71分)、极危重组(≤70分)和死亡组。另收集32例健康儿童作为健康对照组。流式细胞仪检测各组儿童CD3、CD4、CD8、CD56、CD19及CD4/CD8,应用单向免疫扩散法测定其血清IgG、IgM、IgA、C3、C4水平。结果 1.与健康对照组比较,脓毒症组外周血淋巴细胞绝对数及百分比均显著下降(Pa<0.01),且下降程度与疾病严重性和预后不良有相关趋势。2.与健康对照组比较,脓毒症组CD3、CD4和CD19淋巴细胞数量及CD4/CD8显著下降(Pa<0.01),且降低幅度与疾病危重程度存在相关趋势。二组儿童CD8淋巴细胞、CD56细胞数量比较无统计学差异(Pa>0.05)。3.脓毒症组IgG、IgM、IgA水平较健康对照组均明显降低(Pa<0.01)。C3、C4在不同危重程度组间比较无统计学差异(Pa>0.05)。结论 T细胞亚群选择性缺失及体液免疫受损程度在脓毒症发生、发展中起到关键作用。免疫功能受损状况对临床判断脓毒症患儿病情危重程度具有重要意义。
Objective To explore the associations between selective defects of T cell subpopulation and impaired humoral immunity with the occurrence and development of sepsis in children.Methods One hundred and six children with sepsis（sepsis group） were divided into 3 groups according to pediatric critical illness score：non-serious group（〉80 scores）,serious group（80-71 scores）,extremely serious patients group（≤70 scores）,and death group.Thirty-two healthy children were selected as healthy control group.The fluorescence intensity of CD3,CD4,CD8,CD56,CD19 and specific value of CD4/CD8 were detected by flow cytometry.And the content of IgG,IgM,IgA,C3,C4 in se-rum were detected by simple immunodiffusion method.Results 1.Compared with the healthly control group,the absolute number and percen-tage of lymphocytes decreased in the peripheral blood in the sepsis group（Pa〈0.01）.The levels of decrease were correlated with disease severity and prognosis.2.Compared with the healthy control group,children with sepsis had a statistical decrease in CD3,CD4,CD19 lymphocyte percentage and CD4/CD8 ratio（Pa〈0.01）.The levels of decrease were correlated with disease severity.The changes in CD8＋T and CD56 had no significant difference（Pa〉0.05）.3.Compared with the healthy control group,children with sepsis had a statistical decrease of IgG,IgM and IgA（Pa〈0.01）.The percentage of C3 and C4 had no significant change（Pa〉0.05）.Conclusions Selective defects of T cell subpopulations and the decreased concentration of immunoglobulin play a crucial role in occurrence and development process of sepsis.The impaired immune function play an important role in the clinical diagnosis of the disease and its severity in patients with sepsis.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2010年第18期1386-1388,共3页
Journal of Applied Clinical Pediatrics
