儿童病毒性脑炎外周血淋巴细胞亚群的研究.docVIP

儿童病毒性脑炎外周血淋巴细胞亚群的研究 　　[摘要] 目的 观察儿童病毒性脑炎治疗前后外周血淋巴细胞亚群的变化，探讨外周血淋巴细胞亚群的变化对重症病毒性脑炎预后判断的意义。 方法 选取23例重型病毒性脑炎患儿为研究对象，以重型病毒性脑炎患者年龄及性别为依据，1∶1配对选取轻型病毒性脑炎及正常体检儿童组成轻症组及对照组；流式细胞仪检测治疗前后外周血淋巴细胞亚群百分比；轻型病毒性脑炎按脑炎常规治疗，重型者在常规治疗同时应用甲强龙冲击治疗+大剂量IVIG治疗；以出院时无明显神经系统异常归为预后良好组，仍遗留各种神经系统功能障碍或死亡者归为预后不良组。 结果 重症组CD3+、CD4+T淋巴细胞百分比、CD4/CD8值较轻型组与对照组明显减低（P0.05）。 结论 重症病毒性脑炎患儿存在T细胞和B细胞免疫功能紊乱；治疗后CD8+T细胞百分比、CD19+ B细胞百分比无明显变化提示预后不良，甲强龙冲击+大剂量IVIG治疗可能影响CD8+T细胞及CD19+ B细胞百分比。 　　[关键词] 病毒性脑炎；淋巴细胞亚群；预后；IVIG 　　[中图分类号] R725.1 [文献标识码] A [文章编号] 2095-0616（2014）24-14-05 　　Study on peripheral blood lymphocyte subsets in children with viral encephalitis 　　XU Senmao1 HUANG Yaling2 　　1.Department of Pediatric，Anqing Municipal Hospital，Anqing 246003，China；2.Department of Pediatric，the Affiliated Union Hospital of Huazhong Univercity of Science and Technology，Wuhan 430074，China 　　[Abstract] Objective To observe the changes of peripheral blood lymphocyte subsets in children with viral encephalitis before and after treatment；to study the significant of the prognosis of the changes of peripheral blood lymphocyte subsets. Methods 23 cases of severe viral encephalitis children were selected as the research object，according to the age and sex，1：1 light viral encephalitis and normal children composition and the control group before and after treatment in mild group；detection of peripheral blood lymphocyte subsets and the percentage of flow cytometry；light viral encephalitis by encephalitis conventional treatment，heavy application of methylprednisolone therapy with high-dose IVIG treatment at the same time in the conventional treatment；at discharge with no obviousneurological abnormalities into good prognosis group，still left over various neurological dysfunction or deathattributed to the poor prognosis group. Results The percentage of CD3+，CD4+T lymphocyte，CD4/CD8 value of the severe group was significantly lower than that of the light group and the control group（P0.05）. Conclusion T cell and B cell immune function disorder