不同严重程度的病毒性脑炎患儿T 淋巴细胞亚群水平比较

摘要

Objective To analyze T lymphocyte subsets of children with different degrees of viral encephalitis .Meth-ods A total of 100 viral encephalitis children diagnosed and treated in Qilu Children′s Hospital of Shandong University from Jan.2012 to Jun.2015 were included in the study and divided into a mild type group of 58 cases and a gravis type group of 42 cases.The amount of CD3+,CD4+,CD8+T cells and CD4+/CD8+in peripheral blood were compared in the following situ-ations:acute phase and stationary phase ,mild type and gravis type ,prognosis mala and prognosis bona .And compared with 60 healthy check-up center children′s test results.Results The amount of CD3+,CD4+and CD4+/CD8+cells of gravis type group were significantly lower than those of the mild group and healthy group [ ( 52 ±5 )% vs ( 55 ±7 )%, ( 65 ±7 )%;(37 ±6)%vs (40 ±6)%,(52 ±6)%;(1.01 ±0.14) vs (1.16 ±0.21),(1.57 ±0.24),P<0.05],but the CD8+cells were higher than the other two groups [(37 ±4)%vs (36 ±4)%,(35 ±5)%,P<0.05].The amount of CD3+,CD4+and CD4+/CD8+at acute phase were significantly higher than those at stationary phase (P<0.05),but CD8+cell amount was lower(P<0.05).The amount of CD3+,CD4+and CD4+/CD8+cells of patients with prognosis bona were significantly higher than those of prognosis mala[(55 ±6)%vs (50 ±6)%,(40 ±5)%vs (35 ±5)%,(1.15 ±0.21) vs (0.91 ±0.20), P<0.05],and CD8+cells were lower[(35 ±4)%vs (39 ±3)%,P<0.05].Conclusion There are some disorders in cell mediated immunity with both mild type and gravis type childhood viral encephalitis .And the more grievous of the disor-der and the clinical symptoms ,the worse the prognosisis .Paying close attention to T lymphocyte subsets and adjusting the immunologic function early can benefit to the patients with better prognosis .%目的：研究不同严重程度的病毒性脑炎患儿T淋巴细胞亚群水平。方法选择2012年1月至2015年6月山东大学齐鲁儿童医院神经内科收治的病毒性脑炎患儿100例，其中58例轻中症患儿为轻中症组，42例重症患儿为重症组，分别比较急性期和稳定期、轻中症和重症以及预后良好和预后不良患儿外周血CD3＋、CD4＋、CD8＋细胞数量和CD4＋／CD8＋细胞的比值。并与60例健康中心体检儿童检验结果进行对照。结果重症组CD3＋、CD4＋和CD4＋／CD8＋显著低于轻中症组和正常组[（52±5）％比（55±7）％、（65±7）％；（37±6）％比（40±6）％、（52±6）％；（1．01±0．14）比（1．16±0．21）、（1．57±0．24）]（P＜0．05），而CD8＋显著高于轻中症组和正常组[（37±4）％比（36±4）％、（33±5）％]（P＜0．05）；轻中症组CD3＋、CD4＋和CD4＋／CD8＋显著低于正常组（P＜0．05），而CD8＋显著高于正常组（ P＜0．05）。患儿在稳定期CD3＋、CD4＋和 CD4＋／CD8＋三项指标较急性期显著升高（ P＜0．05），而CD8＋细胞数量显著下降（ P＜0．05）；预后良好的患儿急性期CD3＋、CD4＋和 CD4＋／CD8＋显著高于预后不良的患儿[（55±6）％比（50±6）％；（40±5）％比（35±5）％；（1．15±0．21）比（0．91±0．20）]（P＜0．05），而CD8＋低于预后差的患儿[（35±4）％比（39±3）％]（P＜0．05）。结论轻中症和重症病毒性脑炎患儿均可发生细胞免疫紊乱，患儿临床症状越重，紊乱越严重，患儿预后越差。早期关注T细胞亚群水平和调节免疫功能有利于患儿获得更好的预后。