2019 年第 12 期 第 14 卷

传染性单核细胞增多症患儿外周血淋巴细胞亚群及自然杀伤细胞的变化及临床意义

Changes and clinical significance of peripheral blood lymphocyte subsets and natural killer cells in children with infectious mononucleosis

作者：叶翠燕苏宝凤

英文作者：

单位：210006南京医科大学附属南京医院（南京市第一医院）儿科

英文单位：

关键词：传染性单核细胞增多症；T淋巴细胞；B淋巴细胞；自然杀伤细胞

英文关键词：

• 摘要：

• 【摘要】目的    探讨传染性单核细胞增多症（IM）患儿外周血淋巴细胞亚群及自然杀伤细胞的变化及临床意义。方法    选择2016年1月至2018年6月在南京医科大学附属南京医院诊治的48例IM患儿作为观察组，选择同期在我院体检的48名健康儿童作为对照组。观察组患儿静脉滴注更昔洛韦注射液治疗。比较2组间及观察组治疗前后和观察组异型淋巴细胞百分比≥10%与＜10%患儿淋巴细胞及自然杀伤细胞水平。结果    治疗前，观察组患儿的CD+3、CD+8水平明显高于对照组，CD+4、CD+4/CD+8比值、CD+19及自然杀伤细胞水平均明显低于对照组（均P＜0.05）。治疗后，观察组患儿的CD+3、CD+8水平明显低于治疗前［（75±11）%比（82±12）%、（25±4）%比（32±13）%］，CD+4、CD+4/CD+8比值、CD+19及自然杀伤细胞水平明显高于治疗前［（36±9）%比（22±4）%、（1.43±0.38）比（0.68±0.11）、（12.6±4.6）%比（7.3±2.4）%、（11.8±3.9）%比（8.1±2.6）%］（均P＜0.05）。观察组异型淋巴细胞百分比≥10%患儿的CD+4、CD+4/CD+8比值均明显低于异型淋巴细胞百分比＜10%患儿［(21±4)%比(26±6)%、(0.61±0.13)比(0.93±0.27)］，CD+8水平明显高于异型淋巴细胞百分比＜10%患儿［(34±5)%比(28±8)%］（均P＜0.05）；二者CD+3、CD+19及自然杀伤细胞水平比较差异均无统计学意义（均P＞0.05）。结论    IM可导致患儿外周血T、B淋巴细胞亚群及自然杀伤细胞异常，影响患儿的免疫功能，通过检测患儿的淋巴细胞亚群及自然杀伤细胞变化情况可辅助患儿诊断，并为临床采用免疫疗法提供理论参考。

• 【Abstract】Objective    To investigate the changes and clinical significance of peripheral blood lymphocyte subsets and natural killer（NK） cells in children with infectious mononucleosis（IM）. Methods    From January 2016 to June 2018, 48 children with IM（observation group） and 48 healthy children（control group） were enrolled at Nanjing Hospital Affiliated to Nanjing Medical University. The observation group was treated with intravenous administration of ganciclovir. Lymphocyte subsets and NK cells were analyzed between groups and between IM children with the percentage of atypical lymphocytes≥10% or ＜10%. Results    Before treatment, CD+3, CD+8 in the observation group were significantly higher and CD+4, CD+4/CD+8, CD+19, NK cells were lower than those in the control group(all P＜0.05). After treatment, CD+3 and CD+8 significantly decreased［（75±11）% vs （82±12）%, （25±4）% vs （32±13）%］, CD+4, CD+4/CD+8, CD+19 and NK cells significantly increased［（36±9）% vs （22±4）%, （1.43±0.38） vs （0.68±0.11）, （12.6±4.6）% vs （7.3±2.4）%, （11.8±3.9）% vs （8.1±2.6）%］ in the observation group, as compared with before treatment（all P＜0.05）. In the observation group, CD+4, CD+4/CD+8 were lower［(21±4)% vs (26±6)%, (0.61±0.13) vs (0.93±0.27)］ and CD+8 was higher［(34±5)% vs (28±8)%］ with the percentage of atypical lymphocytes≥10% than with the percentage of atypical lymphocytes＜10%（all P＜0.05）, and there were no significant differences in CD+3, CD+19 and NK cells between them(P＞0.05). Conclusions    IM can cause abnormalities of peripheral blood T, B lymphocyte subsets and NK cells, and affects the immune function of children. Detection of lymphocyte subsets and NK cells can provide evidence for the diagnosis and immunotherapy in children with IM.