CD4+CD25+FoxP3+Treg细胞在儿童重症肺炎支原体肺炎中的作用

目的 探讨CD4+CD25+FoxP3+Treg细胞在儿童重症肺炎支原体肺炎(severe mycoplasma pneumoniae pneumonia,SMPP)中的作用.方法 采用流式细胞仪检测65例重症肺炎支原体肺炎患儿(SMPP组)、75例非重症肺炎支原体肺炎患儿(Non-SMPP组)及40例健康儿童(健康对照组)急性期及恢复期外周血CD4+CD25+FoxP3+Treg细胞占CD4+T细胞的比例并进行比较分析.结果 急性期SMPP组CD4+CD25+FoxP3+Treg表达低于Non-SMPP组(0.87±0.66％ vs.1.17±0.70％,P＜0.05)及对照组(0.87 +0.66％ vs.3.88±2.00％,P＜0.01).Non-SMPP组CD4+CD25+FoxP3+Treg表达低于对照组(1.17 +0.70％ vs.3.88±2.00％,P＜0.01).恢复期SMPP组CD4+CD25+FoxP3+淋巴细胞比例较Non-SMPP组降低(1.66±0.85％ vs.3.61±1.45％,P＜0.01).恢复期SMPP组CD4+CD25+ FoxP3+淋巴细胞比例较急性期升高(1.66±0.85％ vs.0.87±0.66％,P＜0.01),恢复期Non-SMPP组CD4+CD25+FoxP3+淋巴细胞比例较急性期亦升高(3.61±1.45％ vs.1.17±0.70％,P＜0.01).结论 CD4+CD25+FoxP3+Treg在SMPP的发病中起一定作用,低表达CD4+CD25+FoxP3+Treg的患儿可能在感染MP后患SMPP的易患性增加,同时影响SMPP患儿预后.     

屋尘螨过敏的支气管哮喘患儿调节性T淋巴细胞水平变化及其临床意义

目的探讨对屋尘螨过敏的支气管哮喘(哮喘)患儿CD4+CD25+Foxp3+调节性T淋巴细胞数量和功能的变化,及调节性T淋巴细胞水平与哮喘严重程度的相关性。方法选择60例对屋尘螨过敏的哮喘患儿,依据临床特征分为轻、中、重3组;同时选择20例健康儿童作为健康对照组。分离所有儿童外周血单个核细胞,予屋尘螨浸出液刺激48 h后,应用流式细胞分析仪检测CD4+CD25+Foxp3+调节性T淋巴细胞和CD4+CD25+Foxp3+IL-10+调节性T淋巴细胞的数量。结果轻度组和中度组哮喘患儿CD4+CD25+Foxp3+调节性T淋巴细胞的数量与健康对照组比较差异均无统计学意义(Pa>0.05),而重度组显著低于健康对照组(P<0.001);哮喘患儿CD4+CD25+Foxp3+IL-10+调节性T淋巴细胞水平与健康对照组比较显著降低(P<0.001),且中度组低于轻度组(P<0.05),而重度组几乎检测不到CD4+CD25+Foxp3+IL-10+调节性T淋巴细胞,其水平显著低于中度组(P<0.01);CD4+CD25+Foxp3+IL-10+T淋巴细胞水平与哮喘患儿疾病严重程度呈负相关(r=-0.637,P<0.05)。结论轻、中度哮喘患儿调节性T淋巴细胞数量无降低,但存在功能障碍,而重度哮喘患儿不仅存在调节性T淋巴细胞功能障碍,而数量降低。CD4+CD25+Foxp3+调节性T淋巴细胞可能在哮喘的发病中发挥着重要作用。     

难治性肺炎支原体肺炎患儿T细胞活化功能状态的变化

目的探讨难治性肺炎支原体肺炎(MPP)患儿T细胞活化功能状态。方法采用免疫荧光标记和流式细胞仪技术对26例难治性MPP患儿外周血T细胞亚群的表面标记和活化后表面分子的表达进行分析,并以18例健康儿童外周血作为对照。结果与对照组比较,难治性MPP患儿CD4 T细胞、CD4 /CD8 值、CD3 /HLA-DR 活化T细胞和T细胞活化后CD3 /CD25 细胞的表达率均显著降低(P均<0.01);难治性MPP患儿CD8 T细胞的表达率明显高于对照组(P<0.01);而CD3 T细胞的表达率在两组间无显著差异(P>0.05)。结论难治性MPP患儿存在T细胞免疫功能紊乱和T细胞活化功能障碍。     

CD4+CD25+Foxp3+调节性T细胞与IL-33在儿童哮喘发病机制中的作用

目的 探讨CD4+CD25+Foxp3+调节性T细胞(Treg)与IL-33在儿童哮喘发病中的作用.方法 采用流式细胞仪检测45例哮喘患儿(哮喘组)、50例呼吸道合胞病毒感染喘息患儿(喘息组)及40例健康儿童(对照组)外周血CD4+CD25+Foxp3+Treg细胞百分比,采用ELISA法检测各组外周血血清IFN-γ、IL-4、IL-5及IL-33浓度,进行比较分析.结果 哮喘组患儿体内CD4+CD25+Foxp3+Treg 水平较喘息组及对照组均降低(P<0.05);哮喘组患儿体内IL-33水平较喘息组及对照组均升高(P<0.05),哮喘组患儿体内CD4+CD25+Foxp3+Treg与IL-33呈负相关(r=-0.156,P<0.01).结论 在哮喘患儿发病机制中,CD4+CD25+Foxp3+Treg与IL-33可能存在相互作用.     

难治性肺炎支原体肺炎患儿肺泡灌洗液中白细胞介素-6、白细胞介素-10及T细胞亚群水平研究

目的 探讨难治性肺炎支原体肺炎患儿肺泡灌洗液(BALF)中白细胞介素(IL)-6、IL-10及T细胞亚群水平变化.方法 选取确诊为难治性肺炎支原体肺炎患儿53例作为观察组,选取同期就诊于我院的支气管异物患儿30例作为对照组.采用双抗体夹心ABC-ELISA法检测BALF中IL-6、IL-10水平及采用流式细胞仪检测T细胞免疫表型CD3+、CD4+和CD8+水平.结果 观察组患儿BALF中IL-6、IL-10水平分别为(63.25±18.61) ng/ml、(31.83±8.33) ng/ml,明显高于对照组的(30.51 ±1.34) ng/ml、(11.01 ±2.91) ng/ml,两组比较差异有统计学意义(P＜0.05);观察组患儿BALF中T细胞亚群CD3+、CD4+、CD8+、CD4 +/CD8+分别为(48.47±2.88)％、(21.16±6.29)％、(23.04±4.63)％、0.94±0.33,明显低于对照组的(64.24±3.06)％、(34.34±7.59)％、(26.71±5.29)％、1.56±0.67,两组比较差异有统计学意义(P＜0.05).结论 难治性肺炎支原体肺炎患儿BALF中IL-6、IL-10水平明显增高及T细胞免疫功能紊乱,提示细胞免疫在难治性肺炎支原体肺炎的发病中起重要作用.     

肺炎支原体致支气管肺炎和大叶性肺炎患儿的临床及实验室检查特征分析

目的分析和探讨肺炎支原体(MP)所致支气管肺炎和大叶性肺炎患儿的临床及实验室检查特征。方法选取于2006年1月—2010年12月住院的社区获得性MP肺炎患儿,根据肺部影像学检查将患儿分为MP-支气管肺炎组151例和MP-大叶性肺炎组89例,收集临床和实验室检查资料并加以分析。结果 MP-支气管肺炎患儿平均年龄为42.7个月,MP-大叶性肺炎患儿平均年龄为63.6个月,差异有统计学意义(P<0.05)。5岁以下患儿以支气管肺炎为多见,而5岁以上患儿以大叶性肺炎多见。MP-支气管肺炎患儿比MP-大叶性肺炎患儿容易出现喘息症状(13.2%对1.1%),而MP-大叶性肺炎患儿更易出现发热(95.5%对78.1%),且发热持续时间长(4 d对8 d),差异均有统计学意义(P<0.05)。MP-大叶性肺炎患儿伴有胸腔积液的比例高于MP-支气管肺炎患儿(9.0%对1.3%)。MP-大叶性肺炎患儿CD3+及CD8+T淋巴细胞的比例高于MP-支气管肺炎患儿,而CD4/CD8比值、CD3-CD19+及CD19+CD23+B淋巴细胞比例低于MP-支气管肺炎患儿,差异均有统计学意义(P均<0.05)。MP-大叶性肺炎患儿的IgA水平高于MP-支气管肺炎患儿,差异有统计学意义(P<0.05),而IgG和IgM的差异无统计学意义。结论 MP-支气管肺炎和MP-大叶性肺炎患儿具有各自的临床和实验室检查特征。MP感染后因不同年龄患儿机体的免疫状态不同,最终导致的疾病转归也不同。     

高敏C-反应蛋白与免疫功能检测在肺炎支原体肺炎中的意义

目的探讨高敏C-反应蛋白(hs-CRP)联合免疫功能检测在儿童肺炎支原体肺炎(MPP)中的临床意义。方法选取单纯MPP患儿103例,分为全身炎症反应综合征(SIRS)组47例和非SIRS组56例,另取26例健康儿童作为对照组,检测hs-CRP、体液免疫指标及细胞免疫指标。结果 SIRS组和非SIRS组的血清hs-CRP、IgG、IgM、CD8+水平显著高于对照组,而IgA、CD3+、CD4+、CD4+/CD8+水平显著低于对照组,差异均有统计学意义(P均0.05);SIRS组的hs-CRP、IgG显著高于非SIRS组,而IgA、CD3+、CD4+、CD4+/CD8+水平则显著低于非SIRS组,差异均有统计学意义(P均0.05);SIRS组和非SIRS组的IgM与CD8+水平的差异则无统计学意义(P0.05)。结论 MPP患儿的体液免疫及细胞免疫功能均有紊乱,且与病情有关;hs-CRP有助于判断儿童MPP病情程度。     

急性特发性血小板减少性紫癜患儿T细胞亚群、NK细胞及IFN-γ、IL-4变化的探讨

目的通过检测急性特发性血小板减少性紫癜(ITP)患儿T细胞亚群、NK细胞、IFN-γ、IL-4,探讨急性ITP患儿的发病机制。方法采用流式细胞仪检测32例急性ITP患儿及20例对照儿童外周血T细胞亚群、NK细胞比例,采用双抗体夹心酶联免疫吸附试验定量方法检测两组儿童外周血IFN-γ、IL-4水平,并采用t检验和直线相关分析进行比较分析。结果急性ITP患儿CD3+、CD4+、CD4+/CD8+细胞水平均明显低于对照组(P值均<0.001),CD8+细胞水平明显高于对照组(P<0.001);NK细胞水平与对照组比较差异无显著性(P>0.05);血清IFN-γ水平明显高于对照组(P<0.01),IL-4水平明显低于对照组(P<0.01);CD4+、CD8+细胞百分比的改变与血小板计数无明显相关性(P>0.05),IFN-γ与IL-4水平呈明显负相关(P<0.001)。结论急性ITP患儿存在T淋巴细胞亚群失衡,同时存在细胞因子紊乱,可能是Th1优势疾病,NK细胞与儿童急性ITP发病机制的关系尚不明确。     

自身免疫性疾病患儿CD4+CD25+调节性T细胞的变化

目的 通过检测外周血CD4+CD25+ 调节性T淋巴细胞(Treg),了解自身免疫病患儿Treg细胞的变化,以期更好的为临床诊断和治疗提供依据.方法 收集2007年11月-2008年6月本院风湿免疫科诊断为自身免疫性疾病患儿93例.本院同期门诊体检健康儿童35例作为健康对照.对发病人数在前3位的类风湿性关节炎(JRA,22例)、SLE(12例)和过敏性紫癜(HSP,12例)分别与健康对照组进行比较.采用流式细胞术检测2组儿童外周血CD4+CD25+ T淋巴细胞和CD4+ T淋巴细胞,计算CD4+CD25+ Treg细胞占CD4+ T淋巴细胞百分数.应用SPSS 11.5统计软件对数据进行独立样本t检验.结果 1.自身免疫性疾病患儿组CD4+CD25+ Treg细胞/CD4+ T淋巴细胞、CD4+CD25+T淋巴细胞分别为(21.85±11.68)%、(6.14±3.21)%,健康对照组为(12.83±3.61)%、(3.68±1.02)%,2组比较前者显著高于后者(Pa<0.05).2.JRA患儿CD4+CD25+ Treg细胞/CD4+ T淋巴细胞、CD4+CD25+T淋巴细胞分别为(19.49±8.60)%、(6.22±3.11)%,SLE患儿为(31.04±17.38)%、(7.38±4.09)%,HSP患儿为(19.0±9.33)%、(5.80±2.44)%,均显著高于健康对照组(Pa<0.05).结论 自身免疫性疾病患儿CD4+CD25+ Treg细胞显著升高,其可能参与了自身免疫性疾病的病理过程.     

CD4~+CD25~+Treg在儿童急性免疫性血小板减少性紫癜发病机制中的作用

目的 研究CD4~+CD25~+调节性T细胞(CD4~+CD25~+Treg)在儿童急性免疫性血小板减少性紫癜(AITP)发病机制中的作用.方法 以25例AITP患儿的外周血为标本,30例健康儿童为正常对照.采用三色单克隆抗体直接标记法检测细胞膜表面抗原;检测胞浆/核抗原时先标记膜表面抗原,固定破膜后再标记胞浆/核抗原;应用多参数流式细胞仪进行Treg细胞的数值检测和结果分析;酶联免疫吸附法检测患儿和正常儿童血清中TGF-β和IL-10水平.结果 约60%的CD4~+CD25~+细胞为FoxP3阳性,而90%以上的CD4~+CD25~(hi)表达FoxP3.AITP患儿与健康儿童CD4~+CD25~(hi)、CD4~+CD25~+FoxP3~+细胞数和CD4~+CD25~+FoxP3~+与CD4~+CD25~+FoxP3~-的比值分别为(0.95±0.27)%对(1.08±0.37)%、(4.54±1.31)%对(5.28±1.52)%和(0.61±0.26)%对(0.73±0.29)%,两组间差异均无统计学意义(P均>0.05);AITP患儿和正常儿童血清的TGF-β水平分别为(9.44±2.78)ng/ml对(25.23±3.42)ng/ml,两者差异有统计学意义(P<0.05);两组间IL-10水平差异无统计学意义.AITP患儿的成熟B淋巴细胞显著高于正常儿童[(19.90±7.42)%对(12.02±3.82)%],P<0.05;NK细胞、CD3~+T细胞和CD3~+CD4~+/CD3~+CD8~+数值在两组间差异无统计学意义(P均>0.05).结论 数量正常但TGF-β分泌不足的Treg细胞,可能在儿童AITP发病中发挥一定的作用.     

Normal and abnormal height and weight development in children and adolescents in Krakow--changes and trends in the last thirty years

The aim of this study is to determine the frequency of height and weight disharmony in children and adolescents in Krakow, i.e. both overweight and underweight in relation to height and the trends in last thirty years. MATERIALS AND METHODS: 4532 individuals -- a random sample of children and adolescents (2416 boys and 2107 girls) were examined in 2000. The results of the examination were compared with data obtain in 1971 (random sample of 4090 individuals) and with results from 1983 (random sample of 6536 individuals). Percentile position of height and weight were compared: the difference of two or more percentiles channels classified the results as overweight or underweight depending on height. THE RESULTS: Of the research prove that the frequency of occurrence of dis-harmonious body built increases with age, both with regard to overweight and underweight related to height and this phenomenon is more frequent in girls. In last thirty years a progressive increase of frequency of overweight was observed, but in girls it was noticeable and statistically significant only in 1971 -- 1983.     

Trends in perinatal and neonatal mortality and morbidity in India

Although the infant mortality rate (IMR) has reduced by 50% during the past century, it compares poorly with the advanced countries and some developing countries. The observed fall in IMR has been mostly in post-neonatal mortality, with the result that neonatal deaths now account for over 60% of all infant deaths. The overall perinatal mortality rate (PMR) in India is still over 50 per 1000 and has shown virtually no decline during the past decade, However, PMR differs widely in different states, urban/rural areas, different hospitals and so on. PMR is seen to correlate better with social development than economic development of the representative community. The causes of perinatal deaths suggest poor health of mother and poor health facilities and are hence potentially preventable. Various studies have shown that PMR can be significantly reduced within a short span of time. The registration of vital statistics continue to be highly unsatisfactory especially in rural areas.     

Bacteriuria in Pregnancy and Infection in Amniotic Fluid and Infant

Women with asymptomatic bacteriuria during pregnancy had sterile amniotic fluid at the time of delivery.There was no evidence that maternal urinary infection was associated with infection in the infant.     

Prevalence of overweight and obesity in children and adolescents in a county in Sweden

Overweight among young people in Sweden is increasing. The aim of the present study was to investigate the frequency of overweight and obesity based on body mass index (BMI) values among children and adolescents. Overweight was defined as a BMI value > or = 91st percentile and obesity as a BMI value > 98th percentile on an international reference BMI curve. The study population included boys and girls from four age groups: 9, 12, 15 and 18 y. The data consisted of self-reported measures of height and weight that were obtained from questionnaires used in a cross-sectional study in December 1997. A validation study was performed using a part of the study population. A total of 7011 (81.7%) participants completed the questionnaire. The correlation between self-reported estimations and objective measures of height and weight was high in the oldest age groups (0.88-0.98), but lower in the 9-y-old age groups (0.37-0.72). These self-reported estimations in the 9-y-olds were excluded from further analysis. It was found that 12.3%, 11.6% and 11.4% of the boys in the 12-, 15- and 18-y-old age groups and 6.8%, 5.5% and 4.8% of the girls in the same age groups were overweight and 7.9%, 8.9% and 7.3% of the boys and 5.1%, 4.2% and 3.9% of the girls were obese. Conclusion: The prevalence of overweight and obesity was found to be high in the study population and is a serious public health problem. The prevalence of obesity was significantly higher (p < 0.05) in 15-y-old boys living in rural areas than in city and town dwellers of the same age.