中国实用儿科杂志

中国实用儿科杂志

• 论著 • 上一篇    下一篇

2岁以下毛细支气管炎患儿临床特征与淋巴细胞亚群比值关系

  

  1. 苏州大学附属儿童医院呼吸科，江苏  苏州  215003
  • 出版日期:2016-12-06 发布日期:2016-12-09

Relationship between the clinical characteristics and lymphocyte subsets ratio in children under 2 years old with bronchiolitis

  1. Department of Respiratory Medicine，Children Hospital Affiliated to Soochow University，Suzhou  215003，China
  • Online:2016-12-06 Published:2016-12-09

摘要：

目的    探究2岁以下毛细支气管炎患儿临床特征与淋巴细胞亚群比值关系。方法     以2014年1月至2015年9月在苏州大学附属儿童医院呼吸科住院诊断为毛细支气管炎的268例患儿为研究对象，入院后24 h内取静脉血进行流式检测淋巴细胞亚群比值，同时进行多病原检测，并收集其他临床资料与同龄非喘息肺炎患儿淋巴细胞亚群进行比较。结果    毛细支气管炎患儿占同期2岁以下住院病例的11.84%。病原阳性检出率57.84%，病原阳性检出排序为呼吸道合胞病毒（21.27%）、肺炎支原体（16.42%）、流感嗜血杆菌（10.07%）、肺炎链球菌（8.96%）。毛细支气管炎组和非喘息肺炎组CD3+、CD3+CD8+比值均低于正常对照组；毛细支气管炎组CD4+/CD8+比值最高，正常对照组最低，毛细支气管炎与非喘息肺炎组CD3-CD19+比值均高于正常对照组（P＜0.05）。结论    毛细支气管炎患儿存在与哮喘相似的淋巴细胞亚群失衡。6个月至1岁儿童更易发生毛细支气管炎。毛细支气管炎特别是过敏体质患儿可能存在B细胞表达水平增强倾向。呼吸道合胞病毒仍是毛细支气管炎最主要病原体。

关键词: 毛细支气管炎, 淋巴细胞亚群, 婴幼儿

Abstract:

Objective    To determine the relationship between clinical features of bronchiolitis in children under 2 years old and  lymphocyte subsets ratio. Methods    Two hundred and sixty-eight hospitalized children in Children Hospital of Soochow University from January 2014 to September 2015 were enrolled in this study. Peripheral blood was collected and cellular immunity was detected by flow cytometry. Pathogens were tested and patients’ clinical data was collected. Results    Bronchiolitis infants were identified in 11.84% of 2264 patients in corresponding period. Prevalence rate of pathogen was 57.84%，whose sequence was（from high to low） respiratory syncytial virus（RSV，21.27%），mycoplasma pneumoniae（MP，16.42%），Haemophilus influenzae（10.07%），Streptococcus pneumoniae（8.96%）. CD3+，CD3+CD8+ ratio of the children with bronchiolitis and without wheezing patients was lower than healthy control group. The CD4+/CD8+ ratio was the highest in bronchiolitis group，which was the lowest in healthy control group. The CD3- CD19+ ratio was higher in bronchiolitis and no-wheezing group than in healthy control group（P＜0.05）. Conclusion    Lymphocyte subsets disorder in brochiolitis children was samilar to that in asthma patients. Children between 6 months and 1 year old were more likely to develop bronchiolitis than the other two groups. Bronchiolitis infants may have high expression tendency of B lymphocyte，especially those with allergic symptoms. RSV is still the most common pathogen in bronchiolitis.

Key words: bronchiolitis, lymphocyte subsets, child