摘要
目的分析肺炎链球菌(SP)肺炎、呼吸道合胞病毒(RSV)肺炎患儿外周血25羟基维生素D(25-OHVD)、T淋巴细胞亚群、B淋巴细胞以及自然杀伤(NK)细胞的变化。方法对入院60例儿童行多病原联合检测,包括直接免疫荧光法检测7种病毒抗原、痰细菌培养、聚合酶链反应(PCR)检测痰中人类偏肺病毒和博卡病毒、酶联免疫吸附测定(ELISA)法检测血清肺炎支原体IgM抗体,明确SP、RSV感染,并用流式细胞仪检测部分患儿外周血T淋巴细胞亚群、B淋巴细胞以及NK细胞,ELISA法进行25-OH-VD水平的测定。并以30例同龄健康儿童作为对照组。结果 RSV肺炎患儿25-OH-VD、CD8+T细胞及NK细胞比对照组低,分别为:46.20(42.85)nmol/L vs 68.25(19.23)nmol/L,(16.63±4.56)%vs(22.04±3.40)%,6.70(7.00)%vs 13.65(5.10)%(均P<0.05);但CD4+T细胞、B淋巴细胞CD19+较对照组高,分别为:(42.58±6.88)%vs(36.20±3.04)%,(28.25±8.85)%vs(19.38±5.76)%(均P<0.05)。SP肺炎患儿25-OH-VD及NK细胞比对照组低,分别为:61.80(15.70)nmol/L vs 68.25(19.23)nmol/L,6.25(7.57)%vs 13.65(5.10)%(均P<0.05);B淋巴细胞CD19+较对照组高,(29.70±9.72)%vs(19.38±5.76)%(P<0.05)。两感染组比较,RSV组CD4+T细胞升高,而CD8+T细胞明显下降。结论 SP、RSV感染的发生与维生素D缺乏密切相关。RSV感染后刺激机体产生细胞免疫和体液免疫反应,而SP感染后则产生以体液免疫为主的免疫反应。
Objective To analyze the changes o{ 25-hydroxy vitamin D（25-OH-VD）,T lymphocyte subsets,B lymphocyte and natural killer （NK） cells in children with streptococcus （SP） or respiratory syncytial virus （RSV） pneumonia. Methods Muhi-pathogen detection including direct fluorescence antibody test（DFA） ,bacteria culture,PCR and ELISA were applied in the patients with RSV or SP pneumonia. T lymphocyte subsets,B lymphocyte and NK cells in peripheral blood in part of patients were examined by flow cytometry and enzyme-linked immunosorbent assay （ELISA） was used to determine 25-OH-VD. While 30 healthy children were included as the control group. Results Compared with the controls,B cell increased in the patients with SP pneumonia （group SP）, （29.70± 9.72）% vs （19.38±5.76） % （ P 〈0.05）, NK cell and 25-OH-VD decreased in group SP, 6.25 （3.43-11.00）% vs 13.65 （11. 10- 16.20）% ,61.80（54.25-69.95） nmol/L vs 68.25（59.12-78.35） nmol/L（ P 〈0.05）. In contrast,CD4＋ T,B cell and the ratio of CD4＋/CD8＋ were higher in the patients with RSV pneumonia（group RSV） than those in the controls, （42.58±6.88）% vs （36.20±3.04） %, （28.25±8.85） % vs （19.38±5.76） %, （2.75±0.85） vs （1.65±0.35）（ P 〈 0.05）. But CD8＋T,NK cells and 25-OH-VD were lower in group RSV than those in the controls,（16.63±4.56）% vs （22.04± 3.40）%,6.70（5.07-12.07）% vs 13.65（11.10-16.20）%,46.2（34.32-77.17） nmol/L vs 68.25（59.12- 78.35） nmol/L（ P 〈0.05）. The children with RSV infection had a high level of CD4＋ T lymphocyte and those with SP infection had a high level of CD8 ± T lymphocyte, （42.58 ± 6.88 ） % vs （36.93 ± 8.82 ） %, （ 16.63 ± 4. 56 ） % vs （ 20.91 ± 6.96） %（ P 〈0.05）. Conclusion SP,RSV infection associated with vitamin D deficiency. RSV infection caused cell immunity and humoral immunity response,SP infection mainly caused humoral immunity response.
出处
《临床荟萃》
CAS
2013年第9期979-981,共3页
Clinical Focus
