Abstract:

To approach variance of the cellular immunological function of the confirmed cases of those  children with H1N1 influenza. Methods　A total of 86 confirmed cases with the novel H1N1 influenza A virus infection，including critical group and severe group

，were diagnosed according to the criteria of the Center for Disesse Control and Prevention of China from October 2009 to January 2010 in our department . Their cellular immunity function were tested with flow cytometry，and the lymphocyte subsets of 23 children in the Department of Surgery were set as the control group. Results　Compared with group，percentage of CD3+，CD3+CD4+，CD3+CD8+ subsets decreased obviously in critical group and severe group，with no significant variance between them； percentage of CD19+CD23+，CD3-CD19+ subsets were presented as control group > severe group > critical group，with obvious statistical variance with each other； percentage of CD3-CD16+CD56+ decreased remarkably in group severe group； however，no statistical result was found with the ratio of CD4+ /CD8+ among all the groups. Conclusion　In Suzhou，children with the pandemic （H1N1） 2009 virus infection have obvious disorder in their cellular immunity function. T lymphocytes are extensively depressed early in the course；B lymphocytes are involved in the virus clearance；decrease of percentage of NK cells has correlation with those critical cases.

Key words: H1N1 subtype, influenza A virus, infection, children, cellular immunity

摘要：

探讨甲型H1N1流感患儿感染后细胞免疫功能的变化。方法　回顾性分析2009年10月至2010年1月苏州大学附属儿童医院收治的86 例甲型H1N1流感确诊病例（分成危重组和重症组）的临床资料；采用流式细胞仪检测患儿外周血T淋巴细胞、B淋巴细胞和NK细胞亚群比例。以23例外科住院患儿的淋巴细胞亚群作为对照组来观察甲型H1N1流感患儿的细胞免疫功能变化特征。结果　（1）CD3+、CD3+CD4+、CD3+CD8+亚群百分比：重症组和危重组较对照组明显降低，而该两组之间差异无统计学意义；（2）CD3-CD19+、CD19+CD23+亚群百分比统计结果示危重组 > 重症组 > 对照组，各组间比较有统计学意义（P < 0.05）；（3）CD3-CD16+CD56+亚群百分比在重症患儿和对照组之间差异无统计学意义，危重组较其他两组均有显著下降；（4）CD4+ /CD8+比值在各组之间差异无统计学意义。结论　甲型H1N1流感患儿感染后细胞免疫功能存在明显紊乱：T淋巴细胞受到全面抑制，B淋巴细胞激活参与病毒的清除，NK细胞比例的降低与危重患儿的病情相关。

关键词: H1N1亚型, 流感病毒A型, 感染, 儿童, 细胞免疫