T淋巴细胞亚群在肺炎支原体感染伴喘息患儿的水平及预后意义

目的 分析外周血T淋巴细胞亚群在肺炎支原体(MP)感染伴喘息患儿中的水平及对其喘息预后的早期预测价值,为临床治疗提供科学依据。方法 选择2017年5-11月潍坊市人民医院妇儿医院小儿内科血清MP抗体阳性住院患儿200例作为单纯MP感染组,其中92例MP感染伴喘息患儿为MP喘息组、108例MP感染不伴喘息患儿为MP非喘息组;选取同期住院89例急性支气管哮喘患儿为哮喘组,检测3组患儿的外周血T淋巴细胞亚群水平,并对92例MP喘息组随访1年。结果 1)MP喘息组进行1年的随访后,反复喘息组70例,喘息终止组17例,失访5例;2)MP喘息组、MP非喘息组的CD3+CD4+、CD3+CD4+/CD3+CD8+淋巴细胞百分比均高于哮喘组(P＜0.05),CD3-CD19+淋巴细胞百分比均低于哮喘组(P＜0.05);3)MP喘息组进行1年的随访后,反复喘息组CD3+CD4+、CD3+CD4+/CD3+CD8+淋巴细胞百分比低于喘息终止组(P＜0.01),CD3-CD19+淋巴细胞百分比高于喘息终止组(P＜0.01)。结论 1)肺炎支原体感染伴喘息患儿存在T淋巴细胞亚群紊乱;2)肺炎支原体感染伴喘息患儿同时伴CD3+CD4+/CD3+CD8+淋巴细胞百分比低时,容易导致反复喘息,甚至发展为哮喘。

Expression and prognosis significance of T lymphocyte subsetsin mycoplasma pneumoniae infection children complicated by wheezing

Objective To investigate the percentage of T lymphocyte subsets and its value in predicting the development of wheezing in infants experiencing their early episodes of wheezing in infants and young children with mycoplasma pneumonia(MP) infection complicated with wheezing,so as to provide scientific evidence for clinical treatment. Methods A total of 200 cases with positive result of MP antibody in the Department of Pediatrics,Weifang People′s Hospital were enrolled in this study as MP infection group from May to November 2017,of whom 92 wheezing cases with MP infection were in MP wheezing group,and 108 cases with MP infection but without wheezing were in MP non-wheezing group.Meanwhile,89 cases with acute bronchial asthma were selected as asthma group.The percentage of peripheral blood T cell subsets in three groups was measured,and 92 cases in MP wheezing group were in followed up for one year.Results 1) After one-year follow-up,70 cases were with recurrent wheezing,17 cases were without wheezing,and 5 cases lost in follow-up.2) MP wheezing group and MP non-wheezing group had significantly more percentage of CD3+CD4+ and CD3+CD4+/CD3+CD8+lymphocytesthan the asthma group,lower percentage of CD3-CD19+ lymphocytes than the asthma (P＜0.05).3) After one-year follow-up in MP wheezing group,the percentages of CD3+CD4+ and CD3+CD4+/CD3+CD8+ lymphocytes in recurrent wheezing group were significantly lower than those in non-wheezing group,and the percentage of CD3-CD19+ lymphocytes was significantly higher than that in non-wheezing group(P＜0.01). Conclusions 1) There is imbalance of T lymphocyte subsets in infants and young children with MP infection complicated by wheezing. 2) Infants and young children with MP infection complicated by wheezing, with lower percentage of CD3+CD4+/CD3+CD8+ lymphocytes, are prone to resulting in recurrent wheezing and even developing asthma.