复发性鼻息肉中T淋巴细胞亚群的表达

目的 :检测复发性鼻息肉组织中T淋巴细胞亚群的表达 ,探讨T淋巴细胞介导的免疫反应在鼻息肉复发中所起的作用。方法 :应用荧光免疫流式细胞术检测 17例复发性鼻息肉患者鼻息肉组织、外周血T淋巴细胞亚群CD4 、CD8 、CD4 5RO 的表达 ,并与正常人下鼻甲黏膜及外周血的相应指标进行比较。 结果 :复发性鼻息肉组织中有大量T淋巴细胞浸润 [(39.6 5±2 .0 8) % ],而在健康下鼻甲黏膜中几乎未见CD3 细胞。在复发性鼻息肉中 ,CD3 CD4 细胞[(6 4.4 46± 5 .2 97) % ]多于CD3 CD8 细胞 [(35 .5 5 4± 5 .2 97) % ](P <0 .0 5 ) ,CD3 CD4 5RO 细胞 [(2 2 .6 49± 2 .789) % ]也显著多于正常人外周血CD3 CD4 5RO 细胞 [(3.896± 0 .384 ) % ](P<0 .0 5 ) ,CD3 CD4 /CD3 CD8 比值为 1.95 6± 0 .0 93,复发性鼻息肉患者外周血比值为 2 .36 7±0 .12 8,正常人外周血比值为 1.6 0 6± 0 .0 96 ,其差异均有统计学意义 (均P <0 .0 5 )。结论 :复发性鼻息肉组织中有大量T淋巴细胞表达 ,且T细胞亚群比例失调 ,显示细胞免疫功能的紊乱在鼻息肉的形成与复发中起重要作用     

鼻咽癌患者外周血淋巴细胞的金属元素与T细胞亚群的研究

目的 :探讨鼻咽癌患者外周血淋巴细胞金属元素和T细胞亚群含量的变化及其与机体免疫功能的关系。方法 :采用日本岛津AA 6 70型原子吸收光谱仪火焰法测定鼻咽癌组和正常对照组外周血淋巴细胞金属元素的含量 ,流式细胞仪测定T细胞亚群。结果 :鼻咽癌组淋巴细胞铜含量显著高于正常对照组 (P <0 .0 1) ,锌含量低于正常对照组 (P <0 .0 5 ) ;鼻咽癌组CD3 、CD4细胞和CD4/CD8比值明显低于正常对照组 (P <0 .0 1)。结论 :鼻咽癌患者外周血淋巴细胞铜含量增高时 ,CD4细胞数量减少 ,表明CD4细胞的克隆发育功能受到影响 ,从而揭示鼻咽癌患者外周血淋巴细胞铜含量的变化与T细胞亚群变化的关系     

睡眠呼吸暂停综合征患者T细胞、NK细胞功能的研究

目的:检测睡眠呼吸暂停综合征(SAS)患者外周血T 淋巴细胞、NK细胞的变化,探讨SAS对细胞免疫功能的影响.方法:应用APAAP桥联酶标法测定外周血淋巴细胞表型.结果:SAS患者组CD3+细胞与正常对照组差异无显著性(P＞0.05)[ WTBZ〗,CD4+、CD4+/CD8+、CD16+、CD25+细胞SAS组均低于正常对照组,而CD8+ 细胞高于正常对照组(P＜0.05,P＜0.01).结论:SAS 患者免疫功能明显降低.     

幼年型复发性呼吸道乳头状瘤病患儿外周血T细胞初探

目的分析幼年型复发性呼吸道乳头状瘤病(juvenile-onset recurrent respiratory papillomatosis,Jo-RRP)外周血T淋巴细胞免疫状态及其与病情间的相关性,探讨更合适的治疗方案。方法采用流式细胞仪检测19例Jo-RRP患儿外周血T淋巴细胞亚群,按照《复发性呼吸道乳头状瘤病病情严重度评分表》对其病情进行严重度评分,分析外周血T淋巴细胞亚群功能及与病情的相关性。结果Jo-RRP患儿CD3~ 、CD4~ 、CD4~ / CD8~ T细胞以及Th1FFh2均低于正常儿童(P<0.05)。除Th1细胞(P<0.05)外,其余免疫指标与Jo-RRP患儿临床严重度评分间均无明显相关性。结论Jo-RRP患儿可能存在T细胞介导的免疫功能障碍,其紊乱的免疫功能与疾病的发生、发展可能存在相互促进作用,需进一步完善手术切除肿瘤之外的免疫调节等辅助治疗手段。     

阻塞性睡眠呼吸暂停低通气综合征患儿扁桃体腺样体切除术后机体免疫功能的变化

目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿进行扁桃体腺样体切除术后机体免疫功能的变化。方法:检测OSAHS患儿扁桃体腺样体切除术前后血清免疫球蛋白IgG、IgA、IgM及CD3、CD4、CD8的水平,比较患儿术前和术后不同时期血清免疫球蛋白和T淋巴细胞亚群的变化。结果:患儿术后IgG、IgA、IgM及CD3、CD4、CD8的水平有所下降,但与术前相比差异无统计学意义。结论:OSAHS患儿进行扁桃体腺样体切除术对细胞免疫和体液免疫影响不大。儿童时期切除扁桃体和腺样体并不损害宿主免疫的完整性或减少宿主的免疫活力。     

手术干预对阻塞性睡眠呼吸暂停低通气综合征儿童外周T淋巴细胞亚群及NK细胞活性的影响

目的　研究阻塞性睡眠呼吸暂停低通气综合征（OSAHS）对患儿细胞免疫功能的影响及手术前后的变化。方法 80例OSAHS患儿,在手术前及手术后1个月对外周血T淋巴细胞亚群及NK细胞比例进行检测。同时选取80例健康儿童作为对照组。结果 与对照组比较,手术前组CD4+T细胞所占百分比、CD4+/CD8+比值、NK细胞所占百分比明显减低[（26.19±3.38）% vs（5.10±4.09）%、（0.90±0.19）% vs（1.61±0.52）%、（11.45±4.35）% vs（13.73±3.78）%,P 均<0.05],CD8+T细胞所占百分比明显升高[（30.02±5.50）% vs（22.31±3.42）%,P <0.05];手术后组CD3+T细胞、CD4+T细胞、CD8+T细胞、CD4+/CD8+比值、NK细胞所占百分比均与手术前组无统计学差异（P 均>0.05）。结论　OSAHS可损害患儿的细胞免疫功能,而扁桃体联合腺样体手术在短期内不会导致患儿细胞免疫功能的减退。     

喉癌患者外周血NK细胞杀伤活性及T淋巴细胞亚群的改变

目的 :探讨喉癌患者外周血NK细胞 (NKC)杀伤活性及T淋巴细胞亚群的改变 ,以评估患者的免疫机能 ,预测预后。方法 :采用乳酸脱氢酶 (LDH)释放法 ,测定NKC杀伤活性 ;应用流式细胞仪检测T淋巴细胞亚群。结果 :喉癌组外周血NKC杀伤活性明显低于正常对照组及声带息肉组 (P <0 .0 5 ) ,病变程度越重 ,NKC杀伤活性越低。喉癌患者术后 3～ 6dNKC杀伤活性明显低于术前 (P <0 .0 5 ) ,7d后呈上升趋势。在NKC杀伤活性降低的同时 ,伴随CD3 、CD4及CD4/CD8比值下降 ,与正常对照组相比较 ,其差异有显著性意义 (P <0 .0 5 )。结论 :检测喉癌患者外周血NKC杀伤活性及T淋巴细胞亚群可客观反映机体免疫状态 ,具有重要临床意义     

慢性扁桃体炎患者外周血T淋巴细胞亚群的分析与临床意义

目的：探讨慢性扁桃体炎患者外周血T淋巴细胞各亚群的变化特点及其与肾损害的关系。方法：采用流式细胞仪检测54例慢性扁桃体炎患者和52例健康体检者的外周血初始T细胞、功能T细胞、激活T细胞及凋亡T细胞亚群百分比,并结合血清半胱氨酸蛋白酶抑制剂（CystatinC）、ASO和ESR水平进行统计学分析。结果：慢性扁桃体炎患者外周血CD3^＋T细胞、CD3^＋CD8^＋T细胞、CD4^＋CD28^＋T细胞、CD8^＋CD28^＋T细胞、CD4^＋HLA—DR^＋T细胞、CD8^＋HLA—DR^＋T细胞、CD8^＋CD95^＋T细胞与健康对照组相应细胞亚群之间的差异无统计学意义（P〉0．05）。但CD4^＋T细胞、CD4^＋CD45RA^＋T细胞和CD4^＋CD25^＋T细胞减少,CD4^＋CD45RO^＋T细胞、CD8^＋CD38^＋T细胞和CD4^＋CD95^＋T细胞增加,CD4^＋／CD8^＋和CD4^＋CD45RA^＋／CD4^＋CD45RO^＋比值下降,与健康对照组相应细胞亚群之间的差异有统计学意义（P〈0．05）。慢性扁桃体炎患者的外周血CD4^＋CD45RA^＋T细胞百分比与其血清Cystatin C浓度负相关。结论：本研究通过对外周血各T细胞亚群变化特点的系统研究,证实了慢性扁桃体炎患者机体存在T细胞免疫平衡紊乱。CD4^＋CD45RA^＋T细胞的变化可以作为慢性扁桃体炎患者肾损害的相关参考指标。     

阻塞性睡眠呼吸暂停低通气综合征患者快速眼动睡眠期呼吸紊乱的特点

目的 :研究阻塞性睡眠呼吸暂停低通气综合征 (OSAHS)患者快速眼动睡眠期 (REM )呼吸暂停低通气的特点。方法 :复习 180例经多导睡眠仪确诊的OSAHS患者的睡眠监测结果 ,使用标准诊断指标睡眠呼吸暂停低通气指数 (AHI)以及睡眠呼吸紊乱时间 (RIT)指数 ,对患者REM期和非快速眼动睡眠期 (N REM)呼吸紊乱的特点进行分析。结果 :轻度患者REM期AHI明显高于N REM期 (P <0 .0 5 ) ,中、重度患者差异无统计学意义。重度患者REM期LSaO2 明显低于N REM期 (P <0 .0 5 )。结论 :①OSAHS患者常随病情加重 ,出现REM期睡眠时间减少甚至消失 ;②REM期呼吸暂停低通气较N REM期严重 ,主要表现在呼吸暂停低通气时间延长 ,而AHI变化不明显 ;③与AHI比较 ,RIT指数与患者呼吸暂停低通气的严重程度更具相关性。     

阻塞性睡眠呼吸暂停综合征患者心律失常的临床分析

目的探讨阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)与心律失常的关系.方法对经多导睡眠仪监测(Polysomnography,PSG)确诊的OSAS 49例行24h动态心电图(Holter)观察,同时选择20例单纯鼾症患者作为对照组.结果OSAS组患者体重、呼吸暂停低通气指数(apnea hypopnea index,AHI)和最低血氧饱和度(lowest saturation,LSaO2)与对照组差异有显著性(P＜0.05, P＜0.01);OSAS组心律失常发生率为51.11%,并且随OSAS病情加重,心律失常发生率升高.结论OSAS患者心律失常的发生与呼吸暂停低通气指数及低氧血症密切相关.     

Early stage impacts of tonsillectomy on immune functions of children

OBJECTIVE: The purpose of this study was to investigate the changes in the humoral and cellular immunity of patients with chronic tonsillitis before and 1 month after tonsillectomy. PATIENTS AND METHODS: 37 patients scheduled for tonsillectomy were enrolled in this study. The levels of CD3+, CD4+, CD8+, CD19+, CD25+ and CD16+ + 56+ were measured for cellular immunity, and levels of IgG, IgA, IgM, C3 and C4 were measured for humoral immunity in blood samples taken from these patients before and 1 month after the operation. RESULTS: The levels of CD3+, CD8+ and CD19+ were reduced in post-operative period as compared to pre-operative period but this was not statistically significant (P > 0.05). However it was found that the level of CD4+ was significantly increased while the level of CD25+ was reduced (P < 0.05) in the post-operative period. There were statistically significant differences between pre- and post-operative levels of immunoglobulins, C3 and C4, which were decreased after tonsillectomy (P < 0.05), but these levels were comparable with those of the control group. CONCLUSION: The results from the present study indicate that humoral and cellular immunity of patients undergoing tonsillectomy were decreased in the early period and came to normal later. The cellular and humoral immune responses are stimulated in patients with tonsillitis, and tonsillectomy removes this stimulus without negatively affecting the patient's immune functions.     

鼻息肉组织中T—细胞亚群的分布及2种白细胞介素表达？…

目的 探讨Ｔ－淋巴细胞及细胞因子白细胞介素（ｉｎｔｅｒｌｅｕｋｉｎ,ＩＬ）调节２功能的紊乱在鼻息肉发病中的重要作用。方法 应用免疫组织化学的方法检测３２例鼻息肉标本和６例下鼻甲粘膜对照标本中Ｔ－细胞亚群（ＣＤ＾＋４和ＣＤ＾＋８细胞）以及细胞因子ＩＬ－５、ＩＬ－１０阳性细胞的表达情况。并进行统计学分析。结果 鼻息肉组织中可见各种炎细胞浸润,ＣＤ＾＋４和ＣＤ＾＋８细胞数增多（Ｐ〈０．００１）;其中ＣＤ     

鼻咽癌患者外周血CD4+CD25high调节性T细胞分析

目的:探讨鼻咽癌患者外周血CD4 CD25h igh调节性T(Tr)细胞比例变化的特点及其临床意义。方法:采用流式细胞术检测54例初治鼻咽癌患者(鼻咽癌组)和15例健康者(对照组)外周血中CD3 、CD4 、CD8 及CD4 CD25h ighT细胞比例。结果:鼻咽癌患者CD4 T细胞比例、CD4 /CD8 比值均低于对照组(均P<0.05),但CD4 CD25h ighTr细胞比例明显高于对照组(P<0.01)。随疾病进展鼻咽癌患者外周血CD4 CD25h ighTr细胞比例升高[Ⅰ Ⅱ期为(2.28±1.07)%,Ⅲ期为(3.65±1.21)%,Ⅳ期为(4.72±0.87)%],Ⅰ Ⅱ期与Ⅲ、Ⅳ期比较,均P<0.01;Ⅲ期与Ⅳ期比较,P<0.01。结论:CD4 CD25h ighTr细胞可能是鼻咽癌患者免疫抑制的重要原因之一,与鼻咽癌免疫逃逸有关。外周血CD4 CD25h ighTr细胞比例可能成为鼻咽癌一种新的预后判断指标,去除这群细胞可有效诱导肿瘤免疫,为肿瘤治疗提供一种新的方法。     

Lymphocyte subpopulations in middle ear effusions

The aim of this study was to identify lymphocytes subpopulations in 55 middle ear effusions and peripheral blood samples from 33 children undergoing myringotomy for otitis media with effusion. CD3+, CD4+, CD8+, CD19+ and NK cell populations were investigated using three-colour monoclonal antibody and flow cytometry to quantitative estimation. CD3+ cells were the predominant cell type in effusions (mean 63.3%). Percentage CD4+, CD8+ cells and CD4+/CD8+ ratio was significantly higher in middle ear effusions than in blood. Lymphocyte subset was compared between 22 pairs of effusions from each patient. Percentage of each cells did not differ significantly. The results of this study indicate local regulation of lymphocyte profile in middle ear effusions and the same stadium of immune response in two ears of the same patient.     

Inflammatory cells in nasal mucosa and nasal polyps

OBJECTIVE: Since some controversy exists concerning the frequency of inflammatory cells in nasal polyps, we have compared the frequency of tissue inflammatory cells (lymphocytes, neutrophils, eosinophils and plasma cells) including 11 kinds of lymphocyte subsets in the same specimens of nasal mucosa and nasal polyps. METHODS: Histopathological observations and flow cytometric analyses were performed on eight mucosal specimens of the inferior turbinates of patients with nasal polyps and on 13 polyp specimens. RESULTS: Nasal polyps contained significantly more eosinophils, neutrophils and plasma cells than nasal mucosa, and EG2+ cells (activated eosinophils) were significantly more frequent in nasal polyps than in nasal mucosa. Flow cytometric analysis showed that there were no significant differences in the frequencies of lymphocytes and lymphocyte subsets (CD1+, CD2+, CD3+, CD5+, CD7+, CD4+, CD8+, CD10+, CD19+, CD20+ and HLA-DR+ cells) including CD4/8 ratios between nasal mucosa and polyps, though, both nasal mucosa and polyps contained significantly more lymphocytes than eosinophils, neutrophils or plasma cells. The T cell lineage (CD2+, CD3+, CD5+ and CD7+ cells) was found in high frequency and B cell lineage (CD10+, CD19+ and CD20+ cells) in low frequency in both nasal mucosa and polyps. The frequency of HLA-DR+ cells (most of which were activated T cells) was not significantly different between nasal mucosa and nasal polyps. CONCLUSION: Histopathological and flow cytometric analyses were performed on the composition of inflammatory cells in nasal mucosa of the inferior turbinates and in polyps from the same patients. The elevated numbers of activated eosinophils, neutrophils and plasma cells in nasal polyps compared with nasal mucosa suggest that inflammatory processes play important roles in the pathophysiology of nasal polyps. The frequencies of lymphocytes and lymphocyte subsets were not significantly different between these two tissues.     

小儿咽喉炎使用复方芩兰口服液的治疗效果研究

目的探讨小儿咽喉炎采用复方芩兰口服液治疗的临床疗效。方法选取2019年10月至2020年12月在我院治疗的小儿咽喉炎68例作为研究对象,按照治疗方法的不同分成观察组和对照组各34例,对照组采用磷酸奥司他韦颗粒治疗,观察组采用复方芩兰口服液,比较两组患儿临床疗效、临床症状消失时间、免疫功能指标、炎性因子水平的影响情况。结果在临床疗效上,观察组明显高于对照组(P<0.05);在临床症状消失时间上,观察组明显短于对照组(P<0.05);在免疫功能指标方面,两组治疗后CD3⁺、CD4⁺较治疗前均有明显上升(P<0.05),治疗后CD8+均明显下降(P<0.05),观察组治疗后CD3⁺、CD4⁺明显高于对照组(P<0.05),CD8+明显低于对照组(P<0.05);在炎性因子水平上,两组治疗后较治疗前均有明显下降(P<0.05),观察组治疗后明显低于对照组(P<0.05)结论小儿咽喉炎采用复方芩兰口服液治方式有明显效果,能够改善患儿的临床症状,提高免疫功能,减少炎症反应,值得临床推广。     

变应性鼻炎患者血清CD23和CD19表达及其与血清总IgE的关系

目的：探讨变应性鼻炎（AR）患者外周血淋巴细胞CD23、CD19表达及其与血清总IgE、鼻部过敏症状的关系。方法：对46例AR患者进行症状评分后,采用流式细胞术及免疫化学发光法检测其外周血淋巴细胞CD23、CD19表达率和血清总IgE水平,并以32例健康体检者为对照。结果：①AR患者外周血CD23^＋、CD19^＋及CD23^＋／CD19^＋淋巴细胞百分率（^-x±s）分别为11.6±1.9、22.8土3.3和10.2±1.7,分别高于对照组（P〈0.05）。②CD23^＋、CD19^＋、CD23^＋／CD19^＋表达百分率与血清总IgE水平、AR症状评分之间存在正相关。③三者之中以CD23^＋／CD19^＋表达百分率与血清总IgE水平、AR症状评分相关性最强（r值分别为0.65和0.49,P〈0.05）。④CD23^＋／CD19^＋与AR症状评分相关程度优于血清总IgE对应值（r=0.33,P〈0.05）。结论：外周血淋巴细胞CD23、CD19表达参与AR发病,并可能是血清总IgE水平的影响因素,检测CD23^＋／CD19^＋表达率有助于对AR病情的判断。     

Surgical outcomes and unique histological features of tonsils after tonsillectomy in adults with periodic fever,aphthous stomatitis,pharyngitis, and cervical adenitis syndrome

ObjectivesData on the adult-onset periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome are scarce. European studies reported that unlike pediatric-onset PFAPA, tonsillectomy is ineffective for adult-onset PFAPA. The aims of this study were (1) to assess the response to tonsillectomy in a cohort of Japanese adult-onset PFAPA patients and (2) to evaluate the histologic appearance of tonsils in adult-onset PFAPA patients and to compare them with those of tonsils from age- and sex-matched controls with chronic tonsillitis.MethodsIn this retrospective cohort study, 5 adults with PFAPA and 15 controls who had undergone tonsillectomy were recruited. The size of the tonsil germinal centers was measured by hematoxylin and eosin staining, and the number and density of B and T lymphocytes in germinal centers were measured by immunohistochemistry, using CD3, CD4 and CD8 as T cell markers and CD20 as B cell marker.ResultsAll patients had complete remission of the symptoms after surgery. PFAPA patients had significantly smaller germinal center areas than controls. The number and density of CD8+ cells in germinal centers were significantly lower in tonsils from PFAPA compared with controls. No differences were found between the two groups in CD3+, CD4+, and CD20+ cells. These results are compatible with the tonsillar features of pediatric-onset PFAPA.ConclusionOur report demonstrates that tonsillectomy might be effective for adult-onset PFAPA and that tonsils of adult- and pediatric-onset PFAPA share the same histological features. These results suggest that the pathogenic mechanisms of adult- and pediatric-onset PFAPA are identical.     

听神经瘤临床特征与细胞免疫的相关性研究

目的　探讨T淋巴细胞在听神经瘤组织及外周血中的表达及其与临床特征之间的相关性。方法　收集65例听神经瘤患者的临床资料,采集外周血,检测各亚型淋巴细胞数量。取肿瘤组织标本进行免疫组化染色,以8例正常颅神经为对照,并与临床资料进行相关分析。结果　65例患者外周血各亚型淋巴细胞数量与临床资料无显著相关性。肿瘤组织中,CD4+和CD8+T淋巴细胞数显著高于对照,且与术前听力水平呈负相关,CD8+T淋巴细胞数与术后面神经功能呈负相关。40岁以下患者中,肿瘤组织CD4+、CD8+T淋巴细胞数显著高于高龄患者。Foxp3在对照组中未见明显表达,与患者术前听力水平呈负相关。结论　T淋巴细胞介导的细胞免疫在听神经瘤的发生发展及患者神经功能的保留和恢复中发挥了重要作用。