过敏性紫癜伴抗MP阳性患儿急性期细胞免疫功能的研究

目的通过流式细胞术检测过敏性紫癜（HSP）并肺炎支原体（MP）感染患儿外周血CD3＋、CD4＋、CD8＋、CD4＋／CD8＋、CD19＋及NK（CD16＋ ＋CD56＋）细胞水平的变化，了解HSP合并MP感染患儿细胞免疫功能状态，探讨MP感染与HSP免疫学发病机制之间的相关性。方法选择53例HSP患儿为研究对象，检测MP—IgM抗体，又分为MP—IgM阳性组和阴性组，并选择20名健康查体儿童为对照组，通过流式细胞仪（FCM）检测所有儿童外周血CD3＋、CD4＋、CD8＋、CD19＋、CD4＋／CD8＋和NK（CD16＋ ＋CD56＋）细胞水平。结果53例HSP患儿中MP—IgM阳性21例，其阳性率高达39．6％；HSP患儿外周血CD4＋细胞和NK（CD16＋ ＋CD56＋）细胞百分率均明显降低，与对照组比较差异有统计学意义（P〈0．01）；CD4＋／CD8＋比值下降（P〈0．05）；CD8＋细胞百分率升高（P〈0．05），CD19＋B细胞显著升高（P〈0．01）；HSP患儿MP感染阳性组与阴性组比较发现，MP感染阳性组CD8＋细胞百分率较阴性组升高，差异有统计学意义（P〈0．05），CD4＋／CD8＋比值和NK（CD16＋ ＋CD56＋）细胞活性下降更显著，与阴性组比较差异有统计学意义（P〈0．05）。结论在HSP儿童中有较高的MP感染率；HSP患儿存在T细胞功能紊乱，NK细胞活性降低，B细胞多克隆活化；说明细胞免疫功能紊乱参与HSP的发病；伴MP感染的HSP患儿细胞免疫功能更加紊乱，表现在CD8＋细胞百分率升高更明显，NK（CD16＋ ＋CD56＋）细胞百分率和CD4＋／CD8＋比值下降更显著；提示MP感染可能在HSP发生、发展中具有重要作用。

Cellular immune function of Henoch - Schonlein purpura combined with MP - IgM positive in children

Objective To investigate the cellular immune function and the changes of CD3 ＋ , CD4 ＋ , CD8 ＋, CD4 ＋/CD8＋ , CD19 ＋ , and the NK cells activity in children with Henoch - Schonlein Purpura （HSP） combined with mycoplasma （MP） infection and investigate the correlation between the MP - infection and HSP. Methods Fifty- three cases with HSP children were choosed and divided into two groups （MP -IgM positive group and negative group）. And 20 cases were selected as the control group in the same period. The activity of NK cells and CD3 ＋ , CD4＋ , CD8 ＋ , C4＋/CD8 ＋ , CD19 ＋ were detected by flow cytometry（FCM）. Results There were 21 children combined with MP infection in 53 children with HSP, and its infection rate was 39. 6%. There was significant difference of CD4 ＋ , CD4 ＋/CD8 ＋ , NK（ CD16 ＋ ＋ CD56 ＋ ）cell in HSP group and control group. There was no significantly difference. There has not significant change in the peripheral blood. The percentage of CD8 ＋ ,CD19 ＋ in HSP group were higher than that of control group （P 〈 0. 01 ）. The percentage of CD8 ＋ cells in MP - IgM positive group was higher that of MP - IgM negative group （P 〈 0. 05）, and the CD4 ＋/CD8 ＋ , NK（ CD16 ＋ ＋ CD56 ＋ ） cells in MP -IgM positive group was lower than that of MP - IgM negative group （P 〈 0. 05）. Conclusions The higher rate of MP infection in children with HSP, the abnormal change of cellular immune function exists in children with HSP. It indicates that cellular immunodeficiency may participate in the pathogenesis of HSP. The higher percentage of CD8 ＋ cells and the lower the NK（ CD16 ＋ ＋ CD56 ＋ ） and CD4 ＋/CD8 ＋ ratio in HSP - MP infection group. It indicates MP infection maybe play an important role in the pathogenesis of HSP.