EBV感染患儿不同疾病型别与其免疫状况的关系

摘要

目的：探析EB病毒（ EBV）感染患儿外周淋巴细胞亚群抗原表达率、血游离EBV-DNA拷贝数与其细胞体液免疫系统之间相关性的关系。方法收集于2010年2月至2012年10月收治的254例患者，179例EBV感染儿童为实验组，排除肝功能异常及疱疹病毒感染儿童75例为对照组。实验组按照临床不同疾病型别分为一般性传染单核细胞增多症（ IM）组87例；重度单核细胞增多症（IM）组32例；慢性活动性EBV感染（CAEBV）组14例及噬血细胞综合征（EBV-HPS）组46例。采用实时荧光定量PCR检测仪、血清免疫球蛋白分析仪、流式细胞仪测定EBV 感染患儿的外周淋巴细胞亚群抗原CD4＋、CD8＋、CD4＋/CD8＋、CD16＋56（NK）表达率。结果 CAEBV组IgE水平明显高于其他4组，差异有统计学意义（P＜0．05）；EBV-HPS组IgG、IgA显著低于其他组别，且C3、C4水平明显低于其余4组，C4数值与其他组比较差异有统计学意义（ P＜0．05）；轻度IM组、中重度IM组的CD8＋的数值明显高于其他组（P＞0．05）；EBV-HPS组细胞总T细胞，CD4＋、CD8＋、CD4＋/CD8＋、NK、B细胞均显著下降，其中除了B细胞与CAEBV组较无差异之外，与其余4组比较有显著性差异（P＜0．05）；CAEBV组CD4＋升高缓慢，CD4＋/CD8＋较其余EBV感染患儿有升高趋势，但与对照组相比差异无统计学意义（ P＞0．05）。结论儿童EBV感染引起的肝脏功能性损伤与T细胞免疫调节失衡有关，不同疫病类型与外周淋巴B细胞体液免疫降低显著度有一定相关性。%Objective To explore the relationship between peripheral lymphocyte subsets antigen expression rate ,serum free EBV -DNA copy number and the humoral immune system of Epstein-Barr virus ( EBV) infection children .Methods Two hundred and fifty-four patients admitted to Youyang People ’ s Hospital from February 2010 to October 2010 were assigned into the experiment group with 179 cases of EBV infection children and the control group with 75 cases of spore rash virus infection children who had no abnormal liver function.The experiment group was further assigned into mild infectious mononucleosis (IM) group(87 cases),serious infectious mono-nucleosis (IM) group(32 cases),chronic active EBV(CAEBV) group(14 cases) and hemophagocytic syndrome (EBV-HPS) group (46 cases).PCR detector cells,serum immunoglobulin analyzer and flow cytometry were used to determine the expression of peripheral lymphocyte subsets antigen CD4 +,CD8 +,CD4 +/CD8 +,CD16 +56(NK) in EBV infection children.Results IgE expression in CAE-BV group was obviously higher than that in the other four groups with significant differences (P<0.05).IgG,IgA in EBV-HPS group was significantly lower than those in other groups ,and C3 and C4 levels significantly lower than the rest of the four groups ,with signifi-cant differences in C4 expression(P<0.05).CD8 +in mild IM group and serious IM group was obviously higher than that in other groups(P>0.05).In EBV-HPS group total T cells,CD4 +,CD8 +,CD4 +/CD8 +and NK,B cells were significantly decreased ,which were significantly different from the other four group except for B cell ,not different from that in CAEBV group (P<0.05).In CAEBV group CD4 +increased slowly ,and CD4 +/CD8 +tended to increase in comparison with other EBV infection children ,yet without signifi-cant differences(P>0.05).Conclusions Liver function injury induced by EBV infection in children is associated with immune regu-latory dysfunction of T cell .Different disease types have a certain correlation with immune decrease significance of peripheral lymph node B cells.