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婴幼儿巨细胞病毒肺炎患儿免疫功能变化的临床分析*
作者:黄中炎1 查琳2 马旺生2 张臣1 刘盼1 汪晓婷1# 
单位:1.武汉科技大学附属武汉市武昌医院儿科 湖北 武汉 420000 2.武汉科技大学附属普仁医院儿科 
关键词:人巨细胞病毒 CMV肺炎 婴幼儿 免疫功能 
分类号:R 563
出版年,卷(期):页码:2024,41(3):253-254
摘要:

 摘要:目的 分析婴幼儿巨细胞病毒肺炎患儿免疫功能的变化,深化对该疾病发病机制的认识。方法 选取2018年9月—2020年1月于武汉科技大学附属武汉市武昌医院及武汉科技大学附属普仁医院就诊的婴幼儿巨细胞病毒肺炎患儿36例为实验组,另选取同期健康体检婴幼儿36例为对照组。采用散射比浊法比较两组患儿血清免疫球蛋白水平,包括IgG、IgA、IgM及补体C3、C4;采用流式细胞仪检测外周血CD3+总T淋巴细胞、CD4+T淋巴细胞、CD8+T淋巴细胞表达率以及CD4+/CD8+T淋巴细胞比值和NK细胞的表达率。结果 两组婴幼儿血清免疫球蛋白及补体水平差异比较均无统计学意义(t=1.981、1.133、0.796、0.173、1.219,均P>0.05);实验组CD3+总T淋巴细胞、CD4+T淋巴细胞、CD4+/CD8+T淋巴细胞比值及NK细胞表达率较对照组明显下降,CD8+T淋巴细胞比值较对照组升高,两组比较差异均有统计学意义(t=4.232、2.135、3.515、5.411、2.705,均P<0.05)。结论 细胞免疫反应在婴幼儿巨细胞病毒肺炎感染发生发展过程中起重要作用,关注患儿免疫调节,可能成为临床诊疗的新思路。

 Abstract:Objective To analyze the changes of immune function in infants with cytomegalovirus pneumonia and understanding of the pathogenesis of the disease. Methods A total of 36 infants diagnosed with cytomegalovirus pneumonia at Wuchang Hospital and Pure Ren Hospital affiliated with Wuhan University of Science and Technology from September 2018 to January 2020 were selected as the experimental group, and 36 healthy infants in the same period were selected as the control group. The levels of serum immunoglobulins, including IgG, IgA, IgM, and complements C3, C4, were compared between the two groups using the nephelometry method. The expression rates of peripheral blood CD3+ total T lymphocytes, CD4+ T lymphocytes, CD8+ T lymphocytes, the ratio of CD4+/CD8+ T lymphocytes, and NK cells were detected by flow cytometry. Results There was no significant statistical difference in serum immunoglobulins and complement levels between the two groups (t=1.981, 1.133, 0.796, 0.173, 1.219, all P>0.05); the expression rates of CD3+ total T lymphocytes, CD4+ T lymphocytes, CD4+/CD8+ T lymphocyte ratio, and NK cells in the experimental group were significantly lower than those in the control group, while the ratio of CD8+ T lymphocytes was higher in the experimental group, with significant differences between the two groups (t=4.232, 2.135, 3.515, 5.411, 2.705, all P<0.05). Conclusion Cellular immune response plays an important role in the occurrence and development of infant cytomegalovirus pneumonia infection. Focusing on immune regulation in affected infants may become a new approach in clinical diagnosis and treatment.

基金项目:
?基金项目:湖北儿科联盟科学基金项目(HBPASF-2019-10);武汉市医学科研项目(WX19Z37)
作者简介:
参考文献:

 参考文献

[1 ] 江载芳,申昆玲,沈颖.诸福棠实用儿科学[M].第八版.北京:人民卫生出版社,2016:910-916.
[2] Yaping Liu,Daniel C Freed,Leike Li,et al. A replication-defective human cytomegalovirus vaccine elicits humoral immune responses analogous to those with natural infection[J]. J Virol,2019,93(23):e00747-19.
[3] Chiereghin Angela,Potena Luciano,Borgese Laura,et al.Monitoring of cytomegalovirus(CMV)-specific cell-mediated immunity in heart transplant recipients:clinical utility of the quantiFERON-CMV assay for management of posttransplant CMV infection[J]. J Clin Microbiol,2018,56(4):e01040-17.
[4] Sergi Pascual-Guardia,Michelle Ataya,Isabel Ramírez-Martínez,et al.Adaptive NKG2C+ natural killer cells are related to exacerbations and nutritional abnormalities in COPD patients[J]. Respir Res,2020,21(1):63.
[5] Yanan Yang,Guohua Ren,Zhifei Wang,et al. Human cytomegalovirus IE2 protein regulates macrophage-mediated immune escape by upregulating GRB2 expression in UL122 genetically modified mice[J].Biosci Trends,2019,13(6):502-509.
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