Mononuclear cell subsets and coronary artery lesions in Kawasaki disease.

The peripheral blood mononuclear cell subsets in patients with Kawasaki disease and coronary artery lesions were investigated. Of the 106 patients 14 had lesions. Patients with Kawasaki disease and coronary artery lesions were found to have increased counts of CD14+ macrophages/monocytes compared with those of patients with Kawasaki disease without lesions. The absolute counts of CD14+ macrophages/monocytes form an important parameter to determine the severity of vascular damage during acute Kawasaki disease.     

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??Abstract??Objective To establish the reference ranges for normal values of peripheral blood lymphocyte subsets in healthy Shanxi children of preschool age. Methods Healthy children aged 3-6 in Taiyuan of shanxi province were enrolled in the study. Relative counts and absolute counts of lymphocyte subpopulations of T cell?? CD3+ CD19-????CD4+ T cell ?? CD3+ CD4+????CD8+ T cell?? CD3+ CD8+????B cell?? CD3- CD19+?? and NK cell?? CD3- CD16+ CD56+?? were detected by three-color flow cytometric analysis. Peripheral blood lymphocyte subsets percentage and absolute counts of lymphocyte subsets in peripheral blood of healthy preschoolers and CD4+ /CD8+ were analyzed?? differences of which were compared between male and female. Results The percentages and absolute values of T cell??CD4+ T cell??CD8+ T cell??B cell and NK cell had no statistically significant difference between the genders ??P??0.05?? in 365 healthy preschoolers. The reference ranges for normal values of T cell??CD4+ T cell??CD8+ T cell??B cell and NK cell respectively were 43.8%??80.3% ??1563??3929 cells/μL????18.8%??46.7% ??738??2001 cells /μL????13.9%??36.1% ??5 32??1549 cells/μL????8.5%??24.6% ??261??960 cells/μL ????4.9%??24.6% ??197??786 cells /μL?? and CD4+ /CD8+ was 0.71??2.39. Conclusion It is important and necessary to establish the normal reference values of peripheral blood lymphocyte subsets for healthy children in the same race and district.It's shown here that there is no statistical difference in the peripheral blood lymphocyte subpopulation distribution between male and female in healthy preschool children.     

Interleukin-6 and Thrombocytopoiesis: Probable Role of Platelets During Acute Phase Responses

Recovery of cell-mediated immunity after cessation of chemotherapy for childhood acute lymphoblastic leukemia (ALL) was investigated in 14 children to monitor the duration of immune deficiency. The numbers of blood T cells and their subsets were analyzed at 0. 1, 3, 6, 9 and 12 months after discontinuation of therapy with monoclonal antibodies and flow cytometry. The total T-cell count was low at cessation but normalized at 1 to 3 months, whereas the T-cell subsets CD4 +, CD8+ CD4+ Leu8 -, and CD4 + CD45RA + recovered differently, In children ages 3 to 6 years, the numbers of CD4 + cells and their subsets were normal at cessation, whereas in children ages 7 to 18 years, CD4+ and CD4+Leu8+ cell counts normalized only at 6 months. The numbers of CD8 + cells or activated T cells were not increased and the CD4 + /CD8 + ratio was not inverted, unlike recovery after bone narrow transplantation. Although the groups showed a mean reversion to normal values by 6 months, there were individual patients who continued to have subnormal values for I year after therapy, some of whom exhibited increased susceptibility to infections.     

Recovery of Blood T-Cell Subsets After Chemotherapy for Childhood Acute Lymphoblastlc Leukemia

Recovery of cell-mediated immunity after cessation of chemotherapy for childhood acute lymphoblastic leukemia (ALL) was investigated in 14 children to monitor the duration of immune deficiency. The numbers of blood T cells and their subsets were analyzed at 0. 1, 3, 6, 9 and 12 months after discontinuation of therapy with monoclonal antibodies and flow cytometry. The total T-cell count was low at cessation but normalized at 1 to 3 months, whereas the T-cell subsets CD4 +, CD8+ CD4+ Leu8 -, and CD4 + CD45RA + recovered differently, In children ages 3 to 6 years, the numbers of CD4 + cells and their subsets were normal at cessation, whereas in children ages 7 to 18 years, CD4+ and CD4+Leu8+ cell counts normalized only at 6 months. The numbers of CD8 + cells or activated T cells were not increased and the CD4 + /CD8 + ratio was not inverted, unlike recovery after bone narrow transplantation. Although the groups showed a mean reversion to normal values by 6 months, there were individual patients who continued to have subnormal values for I year after therapy, some of whom exhibited increased susceptibility to infections.     

Prediction of engraftment after peripheral blood stem cell transplantation by CD34-positive cells in grafts

total of 91 peripheral blood stem cell collections were performed in 26 children with various malignant tumors and peripheral blood stem cell transplantations (PBSCT) were performed in 15 of the children. There was a positive correlation between logarithm of total CD34⁺ cells/kg and logarithm of colony-forming unit-granulocyte macrophage (CFU-GM)/kg (r = 0.86). The time elapsed until the white blood cells (WBC) exceeded 1000/μL was related to both CFU-GM (r = 0.67) and CD34⁺ cell count (r = 0.60). The number of days elapsed until platelet count exceeded 5 times 10⁴/μL was not related to the logarithm of CFU-GM count/10⁵ per kg transfused (r = 0.47), but was related to the logarithm of CD34⁺ cell counts/10⁶ per kg transfused (r = 0.73). The number of days elapsed until the reticulocytes exceeded 5 times 10⁴/μL was not related to the logarithm of CFU-GM count/10⁵ per kg (r = 0.52), but was related to the logarithm of CD34⁺ cell counts/10⁶ per kg transfused (r = 0.91). Although CD34⁺ cell counts correlated with the number of CFU-GM, bone marrow regeneration rates in three lineages were predicted more accurately by the number of CD34⁺ cells transfused than by the number of CFU-GM. These results suggest that measurement of the CD34⁺ cell count may be useful in predicting bone marrow regeneration rate after PBSCT.     

Infliximab regulates monocytes and regulatory T cells in Kawasaki disease

Background

The effect of infliximab (IFX ) on immune cells has not been fully reported in Kawasaki disease (KD ). To investigate the mechanism of IFX in KD , we examined changes in the abundance of CD 14⁺CD 16⁺ activated monocytes, regulatory T cells (T_reg) cells, and T‐helper type 17 (Th17) cells following treatment with IFX .

Methods

We collected peripheral blood from patients with i.v. immunoglobulin (IVIG )‐resistant KD and analyzed absolute CD 14⁺CD 16⁺ monocyte, T_reg (CD 4⁺CD 25⁺FOXP 3⁺) and Th17 cell (CD 4⁺IL ‐17A⁺) counts on flow cytometry. We also measured changes in serum soluble interleukin (IL )‐2 receptor (IL ‐2R), IL ‐6, and tumor necrosis factor (TNF )‐α on enzyme‐linked immunosorbent assay.

Results

T_reg cells and Th17 cells significantly increased after IFX treatment compared with baseline (126 ± 85 cells/μL vs 62 ± 53 cells/μL, P < 0.01; 100 ± 111 cells/μL vs 28 ± 27 cells/μL, P < 0.05, respectively). In contrast, in a subgroup of patients with CD 14⁺CD 16⁺ monocytes above the normal range before IFX , the CD 14⁺CD 16⁺ monocytes significantly decreased following IFX treatment (72 ± 51 cells/μL vs 242 ± 156 cells/μL, P < 0.05).. Serum TNF ‐α did not change, but soluble IL ‐2R and IL ‐6 decreased after IFX treatment.

Conclusion

IFX could downregulate activated monocytes and upregulate T_reg cells towards the normal range. IFX treatment thus contributes to the process of attenuating inflammation in KD .

     

Lymphocyte subsets identified by monoclonal antibodies in healthy children

The distributions of lymphocyte subsets and monocytes in the peripheral blood mononuclear leukocytes of 72 normal children from 2 months to 13 5/12 yr were examined using quantitative immunofluorescence analysis with monoclonal antibodies. Distinct decreases with age were found in the total leukocyte counts, the percentages and the absolute numbers of peripheral blood mononuclear leukocytes. The percentages of Leu-2a+ cells, Leu-7+ cells, and Leu-M3+ cells significantly increased with age, whereas the percentages of Leu-3a+ cells, Leu-4+ cells, and 2H7+ cells significantly decreased with age. As a result, ratios of Leu-3a+/Leu-2a+ decreased with age. No prominent differences with age were found in the proportions of Leu-10+ cells and HLA-DR+ cells.     

静注免疫球蛋白及地塞米松对特发性血小板减少性紫癜患儿免疫功能的影响

探讨大剂量地塞米松 (DEX)及静注免疫球蛋白 (IVIG)治疗 ,对特发性血小板减少性紫癜 (ITP)患儿外周血 T淋巴细胞亚群及免疫球蛋白的影响 ,在以DEX、IVIG治疗 ITP患儿 ,治疗前后各抽血一次 ;以 APAAP法测定 T淋巴细胞亚群 ,以单向琼脂免疫扩散法测定免疫球蛋白。结果表明 1.ITP患儿外周血 CD4+ 降低 ,CD8+增高 CD4+ /CD8+ ,显著降低。单纯 DEX组治疗后 ,CD4+、CD8+均显著降低 ,CD4+ /CD8+升高 ,Ig A、Ig G、Ig M降低 ;单纯 IVIG组治疗后 ,CD8+显著降低 ,CD4+ /CD8+升高 ,Ig G显著升高。2 .单纯 DEX组治疗后 ITP患儿外周血白细胞计数显著高于治疗前 ,单纯 IVIG组与 IVIG加 DEX组治疗前后无显著差异。治疗过程中院内交叉感染率单纯 DEX组为 31.43% ,单纯 IVIG治疗组为 2 5 % ,IVIG加 DEX组为2 8.5 7%。因此 ,本文认为 ITP患儿外周血 T淋巴细胞亚群表达异常 ,IVIG及 DEX治疗均干扰了 ITP患儿机体的免疫状态     

Lymphocyte subsets in whole blood and isolated mononuclear leucocytes of healthy infants and children

The determination of lymphocyte subsets utilizing monoclonal antibodies and flow cytometry has become essential in the evaluation of immunological status. Using a standardized method it was found that in healthy children the percentage of CD 8+ (Leu 2+) positive cells increases significantly (P<0.01) during infancy, whereas the percentage of CD 4+ (Leu 3+) positive cells decreases with age (P<0.01). The percentage of CD 3+ (Leu 4+) cells remains constant. The ratio of CD 4/CD 8 positive cells is significantly (P<0.001) higher in infants than in older children. Other subpopulations (HLA DR+, Leu 7) were found to be constant in all age groups. For the comparison of data on lymphocyte subsets obtained by flow cytometry a standardized test procedure is important.     

Proliferative responses of CD4+ T-cell population to ovalbumin in patients with atopic dermatitis who are sensitive to hen eggs

Proliferative responses of peripheral blood mononuclear cells and T cells with monocytes to ovalbumin were significantly higher than those of B cells with monocytes to ovalbumin in patients with atopic dermatitis (AD) who were sensitive to hen eggs. The CD4+ T-cell/CD8+ T-cell ratios (the values obtained by dividing the maximum stimulation index of CD4+ T cells with monocytes to ovalbumin by the maximum stimulation index of CD8+ T cells with monocytes to ovalbumin) were significantly higher in AD patients sensitive to hen eggs than in non-atopic healthy controls. The proliferative responses of CD4+ T cells with monocytes to ovalbumin were more intensive than those of CD8+ T cells with monocytes in patients with AD sensitive to hen eggs compared with non-atopic healthy controls. These results suggest that the cells responding to ovalbumin are predominantly CD4+ T cells. However, there was no relationship between the stimulation index of proliferative responses of peripheral blood mononuclear cells to ovalbumin and RAST scores for hen eggs. Thus it is possible that the majority of the CD4+ T cells which respond to ovalbumin are not CD4+ helper T cells for IgE production.     

Immunotherapy with autologous dendritic cells and tumor-specific synthetic peptides for synovial sarcoma

Synovial sarcoma in an 11-year-old Japanese girl relapsed 5 months after autologous stem cell transplantation. Autologous dendritic cells (DCs) were generated from her peripheral blood mononuclear cells using granulocyte/macrophage colony-stimulating factor and IL-4. Dendritic cells were pulsed with synthetic peptides containing a junctional region of SYT-SSX2 fusion protein generated by t(X;18) and were administered once per week. No side effects were observed. Growth of metastatic nodules in the lung was temporally suppressed. The delayed-type hypersensitivity responses in skin were enhanced to tumor lysate but not to peripheral blood mononuclear cell lysate. The CD3+ cells cultured with pulsed DCs lysed tumor cells in vitro. Immunotherapy using DCs and tumor-specific peptides may be a safe approach in the treatment of childhood cancer.     

Toll样受体信号途径活化在川崎病免疫发病机制中的作用

目的探讨Toll样受体(TLR s)信号途径在川崎病(KD)免疫发病机制中的作用。方法急性期KD患儿16例,正常同年龄对照组16例。KD患儿分别于静脉丙种球蛋白(IVIG)治疗前后直接取血备检,未加任何体外丝裂原刺激培养。采用逆转录-聚合酶链反应(RT-PCR)及荧光定量PCR检测外周血单个核细胞TLR s 1~10,MD-2,MyD88,IL-1,βIL-6及IL-8 mRNA的表达;流式细胞术分别检测单核/巨噬细胞表面TLR s 2、4及共刺激分子CD80、CD86的表达。结果(1)急性期KD患儿TLR4 mRNA及蛋白表达均显著高于正常同年龄对照组[Real-tim e PCR(325.22±50.34)vs.(2.20±0.23),P<0.01);流式细胞术检测(15.96±5.94)%vs.(3.21±0.62)%,P<0.01],其他TLR表达无明显改变;(2)TLR4传导途径相关因子MD-2及MyD88亦明显增高(P<0.01),IVIG治疗后有不同程度下降;(3)急性期KD患儿组单核/巨噬细胞表面共刺激分子及前炎症细胞因子表达亦明显增高(P<0.01)。结论急性期KD患儿TLR4及其相关分子MD-2、MyD88异常增高,提示TLR4异常活化可能是KD免疫功能紊乱的始动因素之一。     

CD25+CD4+ regulatory T cells in patients with Kawasaki disease

OBJECTIVE: To investigate whether the CD25 + CD4 + regulatory T-cell population, which plays important roles not only in maintaining immunologic self-tolerance but also in controlling the magnitude and character of antimicrobial immune responses, is related to the pathophysiology of Kawasaki disease (KD). STUDY DESIGN: The patient group consisted of 54 patients (median age, 30 months; 27 female and 27 male patients) fulfilling the criteria for KD. Age-matched control subjects included 17 patients with active infections and 24 healthy children. We analyzed CD25 + CD4 + cells and the mRNA expression of Foxp3, cytotoxic T lymphocyte-associated antigen 4 (CTLA4), glucocorticoid-induced tumor necrosis factor receptor (GITR), and transforming growth factor beta in peripheral blood mononuclear cells and purified CD4 + T cells. RESULTS: The proportions of CD25 + CD4 + cells in patients with acute-phase KD (median, 2.35% of total lymphocytes) were significantly lower than those in healthy control subjects (median, 3.14%) and control subjects with disease (median, 3.15%). The proportions returned to the normal level after intravenous gammaglobulin treatment (median, 3.86%). The mRNA expression of Foxp3, CTLA4, and GITR showed similar tendencies. CONCLUSIONS: The decrease of CD25 + CD4 + regulatory T cells in the acute phase might have a role in the development of KD.     

肺炎支原体感染患儿T淋巴细胞亚群检测及分析

目的　观察肺炎支原体肺炎患儿急性期外周血T淋巴细胞亚群、T淋巴细胞活化状态的改变,探讨其发病机制。方法　采用流式细胞仪技术检测了2 0 0 2年1 0月至2 0 0 3年6月就诊于上海市金山区中心医院的1 7例肺炎支原体肺炎患儿急性期外周血T淋巴细胞亚群及T细胞亚群上CD2 5+的表达和CD4+细胞上CD4+CD45RA+、CD4+CD45RO+的表达;对照组为1 0例健康体检儿童。两组年龄、性别差异无显著意义。结果　肺炎支原体肺炎患儿急性期外周血CD3 +百分率( % )为( 62 . 2 3±6 .2 7) ,较对照组( 68 .60±4. 74)低,差异有显著性意义(P <0 . 0 5) ;CD4+、CD8+百分率较对照组差异无显著性意义(P >0. 0 5) ;CD8+CD2 5+百分率( % )为( 0 . 61±0 . 58) ,较对照组( 2 .1 6±0 . 40 )降低,差异有极显著性意义(P <0 .0 1 ) ;CD4+CD45RA+/CD4+CD45RO+比值与对照组相比降低(P <0 . 0 5)。结论　肺炎支原体肺炎时存在细胞免疫失调,主要表现为总T细胞降低,T细胞活化障碍和CD4+CD45RA+/CD4+CD45RO+平衡失调。     

连续血液净化对严重脓毒症患儿T细胞亚群的影响

目的 探讨连续血液净化（CBP）治疗对严重脓毒症患儿T 细胞亚群及预后的影响。方法 选择严重脓毒症患儿42 例,随机给予常规治疗（对照组,22 例）和常规治疗+CBP 治疗 （CBP 组,20 例）,分别于治疗前及治疗后3 d、7 d 动态测定外周血调节性T 细胞亚群的变化及相关临床指标。结果 CBP 组患儿PICU 入住时间及机械通气时间均明显短于对照组（均PP+、CD4+、CD8+ T 淋巴细胞百分比及PCIS 评分较治疗前明显升高,差异均有统计学意义（P+、CD4+、CD8+ T 淋巴细胞百分比及PCIS 评分明显高于对照组（P+、CD4+、CD8+ T 淋巴细胞百分比、CD4+/CD8+ 比值及PCIS 评分均较对照组明显升高（P结论 CBP 治疗可以提高严重脓毒症患儿受抑制的免疫功能,改善患儿预后。     

川崎病患儿外周血单个核细胞基质细胞衍生因子-1和其受体的变化及意义

目的：观察川崎病(KD)患者血浆基质细胞衍生因子1(SDF1)水平及外周血单个核细胞(PBMC)中SDF1的受体CXCR4mRNA表达变化,并分析其与KD及冠状动脉损害的相关关系。方法：采用ELISA方法及荧光定量PCR技术分别测定12例合并冠脉损害和44例无冠脉损害KD患者的急性期与缓解期血浆SDF1浓度及PBMC中CXCR4mRNA表达变化,并与60例正常人比较。结果：KD患者急性期血浆SDF1蛋白水平为1833±395ng/L;PBMC中CXCR4mRNA表达水平为6.57±2.81较对照组升高(P<0.05,P<0.01);缓解期血浆SDF1蛋白和CXCR4mRNA表达水平较急性期下降(P<0.01),但仍显著高于对照组。KD患者合并冠脉损害者PBMC中CXCR4mRNA表达为8.19±2.39,显著高于无冠脉损害者的6.13±2.77(P<0.01)。结论：KD患者血浆SDF1水平及PBMC中CXCR4mRNA表达是增高的,有可能作为判断KD病情活动状态及冠脉损害的免疫学指标。     

Predictive risk factors for coronary artery abnormalities in Kawasaki disease

Clinical characteristics to predict the development of coronary artery abnormalities (CAA) in Kawasaki disease (KD) were assessed by reviewing medical records of patients diagnosed with KD at Korea University Medical Center from March 2001 to February 2005. Of the 285 patients diagnosed with KD, 19 developed CAA (6.7%). Compared with the CAA(−) group, the CAA(+) group had a longer duration of fever after intravenous gamma-globulin (IVGG) injection (2.4±2.9 vs. 1.5±1.2 days, p=0.008) and higher C-reactive protein (CRP)(12.3±7.8 vs. 8.7±7.1 mg/dL, p=0.038). In particular, the CAA(+) group tended to have more than 7 days of fever before IVGG and more than 3 days of fever after IVGG (26.3 vs. 5.3%, p<0.001; 26.3 vs. 6.4%, p=0.002). When the IVGG responsiveness was defined by the presence of defervescence within 3 days after IVGG, IVGG-non-responders showed a higher incidence of CAA (22.7 vs. 5.3%, p=0.002). Non-responders had a longer duration of fever after IVGG (5.5±1.9 vs. 1.2±0.6 days, p<0.001) and a significantly increased CRP, AST, ALT and total bilirubin. Multivariate regression analysis for CAA showed that the only factor significantly associated with the development of CAA was total fever that lasted for longer than 8 days (OR=4.052, 95% CI=1.151–14.263, p=0.0293). Conclusively, the most important predictor of CAA in KD is total duration of fever longer than 8 days. Early identification of IVGG non-responders and active therapeutic intervention for fever in KD cases might decrease the incidence of CAA.     

Peripheral blood lymphocyte subsets in children with frequent upper respiratory tract infections

It is a common and well-known fact that infants and preschool children undergo frequent episodes of upper respiratory tract infections. The majority of these children do not have a recognized immunodeficiency. The aim of the present study was to evaluate the effects of frequent upper respiratory tract infections on cellular immunity, using peripheral blood lymphocyte subsets and activation markers as defining parameters. The study group consisted of 16 children (aged 2-6 years) with frequent upper respiratory tract infections; 30 age-matched healthy children served as controls. Peripheral blood T, B, NK cells; T lymphocyte subsets; naive and memory cells; and activation markers were analyzed by using monoclonal antibodies and flow cytometry. White blood cell count (WBC) was found to be markedly increased in the study group compared to controls (p < 0.05). The absolute number of lymphocytes was also higher than that of the healthy children. The relative size of the CD3+CD8+ T lymphocytes and the relative and absolute numbers of CD3-CD16+56+ NK cells were found to be higher in patients than the controls. All the remaining percentages and numbers of the T cell subgroups including naive and memory cells and B lymphocytes did not show any difference, while CD3+CD25+ cell numbers were markedly increased (p < 0.05). In conclusion, the examination of peripheral blood lymphocyte subsets in children with frequent upper respiratory tract infections is important in evaluating cellular immune alterations due to antigenic stimulation; however, it is neither essential nor cost-effective in the management of the disease. This study has shown that both the percentage and absolute numbers of peripheral blood lymphocyte subsets maintain their normal status in children with frequent upper respiratory tract infections.     

人脐血T、B淋巴细胞和NK细胞的免疫学表达特性

目的 探讨人脐血T、B淋巴细胞和NK细胞，以及T／NK细胞杀伤性抑制性受体（KIR）表达的免疫学特性及其意义。方法 应用流式细胞仪检测26例正常新生儿脐血的T、B淋巴细胞和NK细胞抗原标记，包括CD45RA、CD45RO、CD69、CD25、CD40L、CD40、CD10、CD20和CD16等抗原的表达，以及脐血T／NK细胞上KIR分子（CD158a和CD158b抗原）的表达，并与正常儿童外周血比较。结果 脐血T淋巴细胞中CD45RA^ 细胞表达高于外周血（P＜0．01），CD45RO^ 则明显低于外周血（P＜0．01）；脐血T细胞CD69表达极低；CD25在CD8^ 细胞亚群中几乎不表达；CD40L在脐血T细胞中表达低于外周血（P＜0．05）。脐血B淋巴细胞中不成熟亚群CD10^ ／CD19^ 比例增高，成熟B细胞表型CD19、CD20、CD40等抗原均明显高于正常外周血（P＜0．01）。脐血中T淋巴细胞和NK细胞均存在KIR分子表达；脐血和外周血中T淋巴细胞CD158分子表达低于NK细胞（P＜0．01），脐血T淋巴细胞亚群中CD158分子表达低于正常外周血；CD158几乎不表达于CD4^ T细胞，主要表达于CD8^ T细胞，且以CD158a^ 为主；脐血中NK细胞CD158分子表达高于T淋巴细胞（P＜0．05），但明显低于外周血NK细胞KIR的表达（P＜0．01）。结论 脐血T淋巴细胞包括原始和早期T细胞以及T细胞受体表达障碍，导致脐血T淋巴细胞免疫功能不成熟，可能是脐血移植（UCBT）后移植物抗宿主病（GVHD）发生率低和程度轻的重要原因之一。脐血B淋巴细胞免疫应答障碍可能缘于T淋巴细胞表型或功能的障碍。脐血T／NK细胞KIR的表达特性提示，KIR可能与UCBT中GVHD和移植物抗白血病（GVL）效应有关。     

儿童难治性肺炎支原体肺炎常规免疫指标的年龄依赖性变化分析

目的　通过控制年龄因素,探讨难治性肺炎支原体肺炎（RMPP）常规免疫指标变化。方法　回顾性分析2016年1月至2019年12月复旦大学附属儿科医院住院的120例MPP患儿的常规免疫指标。参考中国不同年龄及性别的健康儿童的外周血淋巴细胞亚群的参考值,将120例患儿分为正常或异常组,对于异常组的患儿进一步分为减少组或增多组。比较普通型肺炎支原体肺炎（GMPP）与RMPP两组患儿常规免疫指标的变化的差异性。 结果　RMPP组淋巴细胞亚群异常的患儿比例均高于GMPP组, 两组CD3+, CD19+及NK细胞百分比的差异具有统计学意义（P＜0.05）。两组多数患儿均表现为淋巴细胞计数、 CD3+、 CD4+、 CD8+及NK细胞绝对计数减少。进一步对淋巴细胞减少的亚群分析, 发现两组CD3+及NK细胞计数、 CD3+及NK细胞百分比、 CD4+百分比、 CD4+/CD8+差异具有统计学意义（P＜0.05）。各组血清免疫球蛋白（IgA、 IgM、 IgG、 IgE）水平差异无统计学意义（P＞0.05）。 结论　T细胞及NK细胞在MPP炎性反应中发挥重要作用, CD4+ 细胞及NK细胞与MPP的严重程度相关, 可能是RMPP的免疫致病机制之一。