婴幼儿轮状病毒肠炎细胞免疫功能的研究.DOCVIP

临床医学论文-婴幼儿轮状病毒肠炎细胞免疫功能的研究 ????????????????????????? 作者：张学军，刘作义，尹显贵? 【摘要】? 目的 探讨婴幼儿患轮状病毒(Rotavirus，RV)肠炎时机体的细胞免疫状况,为防治婴幼儿RV肠炎开辟新思路。方法 测定30例婴幼儿RV肠炎血T细胞亚群，与同期11例正常婴幼儿作对照。结果 RV肠炎患儿血中CD3+、CD4+和CD4+/CD8+比值明显低于对照组(P值分别0.01、0.05和0.05)，而CD8+细胞与对照组无显著差异，CD3+、CD4+细胞在RV肠炎的重度较轻度明显减少，差异有显著性(P0.05和0.01)，而CD8+及CD4+/CD8+比值在各种病情中无明显差异。结论 婴幼儿RV肠炎时，细胞免疫功能受到抑制，从而使全身和局部B细胞增殖及抗体的分泌减少，降低对RV感染的保护中和作用。因此，测定CD4+、CD4+/CD8+比值可能对肠炎的预后、疗效和转归有辅助诊断价值。 【关键词】? 轮状病毒肠炎;婴幼儿;T细胞亚群 　　[Abstract] Objective To explore the cell immunity of infants with rotavirus (RV) enteritis and lay the groundwork of new therapy for treating infants with RV enteritis.Methods The blood specimens collected from 30 infants with RV enteritis and control were measured for the level of subset of T lymphocyte.Results CD3+，CD4+ and the ratio of CD4+/CD8+ were reduced obviously in RV enteritis compared with the control(P0.01,0.05 and0.05 respectively),and no difference level of CD8+ were found between RV enteritis group and control,CD3+ and CD4+ were reduced obviously in serious enteritis than light enteritis(P0.05 and 0.01).CD8+ and the ratio of CD4+/CD8+ were no difference in ever state.Conclusion Cell immunity was suppressed and resulted in reducing the proliferation of B lymphocyte and secretion of antibody at system and local in infants with RV enteritis.It is valuable for prognosis of enteritis to measure the level of CD3+,CD4+ and the ratio of CD4+/CD8+. 　　[Key words] rotavirus enteritislinfant;T lymphocyte 　　当今世界，轮状病毒(Rotavirus，RV)胃肠炎严重威胁着婴幼儿的健康和生命。急性腹泻患儿中，有11%~71%(平均33%)由RV引起[1]。住院的婴幼儿胃肠炎约80%为RV感染所致[2]。临床中发现RV肠炎患儿有的表现重，有的表现轻;有的恢复快，有的恢复慢;有的呈无症状感染[3];导致这种情况的原因除与RV的电泳型和基因型有关外，可能还与婴幼儿机体免疫状况有关。我们通过测定RV肠炎患儿血T细胞亚群，来了解患RV肠炎婴幼儿的细胞免疫状况，以探讨RV肠炎的防治新思路。 　　1 对象和方法 　　1.1 对象 选择2008年10月至2009年3月30例RV肠炎的住院患儿，年龄6~17个月(平均8.5个月)，男18例，女12例;大便RV抗原呈强阳性反应，均符合RV肠炎诊断标准[4];且大便普通培养和致病性大肠杆菌培养均为阴性;该研究组患儿平常均健康少病，营养状况良好;治疗以抗病毒、体液疗法为主，未用免疫制剂治疗。对照组11例均为同期同龄正常婴幼儿。 　　1.2 方法 于患儿患病极期，用无菌干燥抗凝瓶收集静脉血1~2 ml，在6 h内，根据免疫荧光技术的原理，应用流式细胞仪测定T淋巴细胞亚群。用Simultest IMK-Lymphocyt