儿童恶性淋巴瘤患者红细胞免疫功能的研究

Ｓｉｅｇｅｌ等１９８１年提出“红细胞免疫系统”概念，开拓了免疫学的新领域，完善了对红细胞免疫功能的认识。研究发展迅速。我们检测了２５例儿童ＭＬ患者红细胞免疫功能状态，并进行了治疗前后的动态观察。２５例ＭＬ患者均为病理组织学确诊的住院病人，其中非何杰金淋巴瘤（ＮＨＬ）１９例，何杰金氏病（ＨＤ）６例。另外将血管瘤、淋巴管瘤、甲状腺囊肿等良性肿瘤３０例作为对照组。结果表明：ＭＬ组的红细胞Ｃ３ｂ受体花环率     

小儿某些血液病红细胞免疫粘附功能的检测及其意义

本文测定急性白血病（ＡＬ）、慢性再生障碍性贫血（ＣＡＡ）、特发性血小板减少性紫癜（ＩＴＰ）和过敏性紫癜（ＨＳＰ）等患儿红细胞免疫粘附功能，结果表明，ＡＬ、ＣＡＡ和ＩＴＰ红细胞Ｃ３ｂ受体花环率显著低于对照组（Ｐ〈０．０１），ＨＳＰ则明显高于对照组（Ｐ〈０．０１），各组红细胞免疫复合物花环率无明显变化。随着病情好转，Ｃ３ｂ受体花环率趋于正常。因此，红细胞免疫粘附功能检测对上述血液病的发病和病情观察有一     

贫血患儿红细胞免疫功能观察

为了解贫血患儿的红细胞免疫功能,对 ８５例贫血患儿（缺铁性贫血 ２９例、急性白血病 ２６例、地中海贫血 １８例、再生障碍性贫血 １２例）进行了红细胞 Ｃ３ｂ受体花环率（ＲＢＣ－Ｃ３ｂＲＲ）和红细胞免疫复合物花环率（ＲＢＣ－ＩＣＲ）测定。结果显示所有贫血患儿ＲＢＣ－Ｃ３ｂＲＲ均显著低于对照组儿童（Ｐ＜０．０１）,缺铁性贫血和再生障碍性贫血患儿 ＲＢＣ－ＩＣＲ与对照组比较无明显差异（Ｐ＞０．０５）,急性白血病患儿 ＲＢＣ－ＩＣＲ高于对照组（Ｐ＜０．０５）,地中海贫血患儿 ＲＢＣ－ＩＣＲ则显著高于对照组（Ｐ＜０．０１）。贫血患儿容易感染可能与红细胞免疫功能低下有关。     

川崎病患儿红细胞补体Ⅰ活性及IgE变化

本文检测了１７例川崎病（ＫＤ）患者红细胞补体Ⅰ（ＣＲ－Ⅰ）活性及其调节因子、血清ＩｇＥ水平,并对上述指标进行探讨和分析。对象和方法一、对象　１７例ＫＤ患儿,男１１例,女６例,年龄６ｍｏ～５ａ,符合川崎病诊断标准［１］。１５例健康儿作对照组,平均年龄３ａ５ｍｏ。二、方法　红细胞ＣＲ－Ⅰ活性及其调节因子测定　红细胞Ｃ３ｂ受体花环率（ＲＢＣ－Ｃ３ｂＲＲ）、红细胞免疫复合物花环率（ＲＢＣ－ＩＣＲ）、红细胞免疫促进因子（红细胞Ｃ３ｂ受体花环促进率,ＲＦＥＲ）、红细胞免疫抑制因子（红细胞Ｃ３ｂ受体花环抑制率…     

小儿高白细胞急性白血病31例分析

３１例高白细胞急性白血病（ＨＡＬ）患儿，均经血液、骨髓涂片或病理确诊并具外周血白细胞≥１００×１０９／Ｌ者，高白细胞急性非淋巴细胞白血病（Ｈ－ＡＮＬＬ）１２例，高白细胞急性淋巴细胞白血病（Ｈ－ＡＬＬ）１１例，高白细胞非何杰金淋巴瘤－Ⅳ期（Ｈ－ＮＨＬⅣ期）８例。ＨＡＬ起病急，病程＜１月及脏器出血较对照组多（Ｐ＜０．００１）。临床突出表现为白细胞淤滞综合征（１４例），Ｈ－ＡＮＬＬ较Ｈ－ＡＬＬ多见（Ｐ＜０．０５），及化疗后肿瘤溶解综合征（３例），均为Ｈ－ＡＬＬ。白细胞淤滞综合征发生后９例５～７天内死亡，故ＨＡＬ应作急症处理，必须迅速采取降白细胞措施，降低早期病死率。     

围产期窒息和缺氧缺血性脑病红细胞免疫粘附功能及机体免疫状态的研究

目的探讨围产期窒息及缺氧缺血性脑病（ＨＩＥ）时机体免疫状态,特别是红细胞免疫状态的变化与ＨＩＥ发病、病理变化及病情演变的关系。方法应用红细胞酵母菌花环试验、间接免疫荧光流式细胞仪检测法、单向免疫扩散法对围产期窒息及ＨＩＥ患儿红细胞免疫粘附（ＲＣＩＡ）功能,血Ｔ细胞亚群、血清免疫球蛋白及补体进行检测。结果窒息及ＨＩＥ组红细胞Ｃ３ｂ受体花环（Ｅ－Ｃ３ｂＲＲ）较对照组明显降低（Ｐ＜００５和＜００１）,且随着病情加重降低更为明显。在病情恢复期Ｅ－Ｃ３ｂＲＲ较急性期明显增高（Ｐ＜００５）,但仍低于正常组（Ｐ＜００５）。与正常组比较,窒息及ＨＩＥ组ＣＤ３＋、ＣＤ４＋明显降低（Ｐ＜００５）,ＣＤ８＋、ＣＤ４＋／ＣＤ８＋无显著变化。ＨＩＥ组血清ＩｇＧ、ＩｇＡ、ＩｇＭ及补体Ｃ３水平明显降低,且Ｅ－Ｃ３ｂＲＲ与ＣＤ８＋呈负相关,与ＣＤ４＋／ＣＤ８＋及ＩｇＭ呈正相关。结论围产期窒息及ＨＩＥ时红细胞及白细胞免疫功能均低下,且两者之间存在显著的相关性,ＲＣＩＡ功能的变化参与了ＨＩＥ的病理生理过程,可间接反映ＨＩＥ时脑损伤的程度及病情演变过程。     

肾病患儿红细胞补体受体Ⅰ活性及血浆脂质过氧化物水平改变及临床意义

对２５例肾病综合征（ＮＳ）患儿的红细胞补体受体Ⅰ（ＣＲ－Ⅰ）活性及其调节因子、血浆脂质过氧化物（ＬＰＯ）水平进行检测。结果显示ＮＳ患儿红细胞Ｃ３ｂ受体花环率（ＲＢＣ－Ｃ３ｂＲＲ）、红细胞免疫复合物花环率（ＲＢＣ－ＩＣＲ）、红细胞免疫粘附肿瘤细胞能力（ＲＢＣ－ＣａＲ）、红细胞免疫促进因子（ＲＦＥＲ）均低于对照组（Ｐ＜００１），红细胞免疫抑制因子（ＲＦＩＲ）及血浆ＬＰＯ高于对照组（Ｐ＜００１）。提示ＮＳ患儿存在原发性红细胞免疫功能低下，并且与红细胞免疫调节功能紊乱及血浆ＬＰＯ水平有关     

系膜增生性肾小球肾炎红细胞和白细胞免疫粘附功能及其相关性的研究

为从红细胞免疫角度探讨系膜增生性肾小球肾炎（ＭｓＰＧＮ）患儿的免疫发病机制，用郭峰法检测了３１例ＭｓＰＧＮ的红细胞和白细胞免疫粘附功能，并进行比较研究。结果提示：（１）作为检测红细胞免疫粘附功能的红细胞Ｃ３ｂ受体花环经（ＲＣＲ）和肿瘤红细胞花环率（ＴＲＲ）均较对照组明显降低，红细胞免疫复合物花环率（ＲＩＣＲ）差异不显著。（２）作为检测白细胞免疫功能的肿瘤料花环率（ＴＮＲ）和肿瘤淋巴细胞花环率（ＴＬ     

婴儿先天性巨结肠与巨细胞病毒感染

为了解婴儿先天性巨结肠（ＨＤ）与巨细胞病毒（ＣＭＶ）感染的关系，对１９例２～１８个月的ＨＤ患儿（经病理证实）的血清、尿和组织块用病毒分离和ＤＮＡ探针杂交方法进行ＣＭＶ检测。结果：１９例ＨＤ患儿分离ＣＭＶ的１９份尿标本中２份污染，在１７份尿标本中７份阳性，阳性率为４１．２％；正常儿尿标本阳性率为１４．４％（Ｐ＜０．０５）。１９例ＨＤ血清中，ＣＭＶＩｇＭ抗体２例阳性，阳性率为１０．５％；正常儿阳性率为８．０％（Ｐ＞０．０５）。１９例ＨＤ痉挛段组织块中无一例ＣＭＶ阳性，但６例ＨＤ痉挛段组织块ＣＭＶ－ＤＮＡ探针杂交全部阳性，其中２例强阳性，阳性率为１００％。说明婴儿ＨＤ与ＣＭＶ感染关系密切，ＣＭＶ感染可能是包括ＨＤ在内的一些先天性畸形的重要致畸因素。     

新生儿缺氧缺血性脑病血清LDH、CK与同功酶活性的变化及其临床意义

目的探讨新生儿缺氧缺血性脑病（ＨＩＥ）患儿血清乳酸脱氢酶（ＬＤＨ）、肌酸激酶（ＣＫ）及其同功酶活性检测的临床应用价值。方法对４７例ＨＩＥ患儿和３９例正常新生儿采用比色法和电泳法测定其血清中总ＬＤＨ、ＣＫ及其同功酶活性。结果中至重度ＨＩＥ血清总ＬＤＨ、ＣＫ及同功酶ＬＤＨ３、ＬＤＨ４、ＬＤＨ５、ＣＫ－ＢＢ较正常儿明显增高（Ｐ＜００５）,ＬＤＨ１、ＬＤＨ２、ＣＫ－ＭＭ、ＣＫ－ＭＢ仅在重度ＨＩＥ组较正常儿显著增高（Ｐ＜００１）;ＨＩＥ治疗后７天血清ＬＤＨ３、ＬＤＨ４、ＬＤＨ５、ＣＫ－ＭＭ、ＣＫ－ＭＢ、ＣＫ－ＢＢ较出生４８ｈ内明显下降（Ｐ＜００５）,但血清总ＬＤＨ、ＬＤＨ１、ＬＤＨ２、ＬＤＨ３、ＣＫ－ＭＢ、ＣＫ－ＢＢ仍高于同时相正常组（Ｐ＜００５）。结论ＨＩＥ时血清ＬＤＨ、ＣＫ及同功酶,特别是ＬＤＨ３、ＣＫ－ＢＢ可作为评价ＨＩＥ脑损害程度的敏感指标。     

癫痫患儿红细胞免疫功能的研究

目的 探讨红细胞免疫粘附功能与癫痫发作的关系。方法 采用酵母菌花环试验法对７０例癫痫患儿及３０例健康儿童（对照组）进行红细胞（Ｃ３ｂ（ＲＢＣ－Ｃ３ｂ）受体花环率及红细胞免疫复合物ＲＢＣ－ＩＣ）花环率检测,并进行比较。结果（１）癫痫组ＲＢＣ－Ｃ３ｂ受体花环率明显地姐;ＲＢＣ－ＩＣ花环率明显高于对照组;（２）使用抗癫痫药物组患儿ＲＢＣ－Ｃ３ｂ受体花环率明显高于未使用抗癫痫药物组,ＲＢＣ－ＩＣ花环率两组     

毛细支气管炎患儿红细胞免疫及T细胞亚群变化的研究

目的：探讨毛细支气管炎患儿红细胞免疫和T细胞亚群的变化及意义。方法：对45例毛细支气管炎患儿和30例正常儿童的红细胞免疫功能和T细胞亚群进行检测。检测外周血红细胞免疫复合物花环率（RBC-ICR）、红细胞C3b受体花环率（RBC-C3bRR）;采用流式细胞术检测CD3+、CD4+、CD8+细胞亚群。结果：毛细支气管炎患儿RBC-C3bRR［（13.6±6.2）%］、CD8+细胞百分比［（21.6±4.4）%］ 较对照组的（18.0±7.4）% 和 (25.6±5.2)%减低（P<0.01）;CD3+［（59.9±6.7）%］和CD4+细胞百分比［（53.5±6.2）%］及RBC-ICR［（8.3±3.5）%］均高于对照组的（52.1±8.3）%、（46.8±4.9）% 和（6.1±2.5）%（P<0.01）。毛细支气管炎患儿RBC-ICR和CD4+细胞百分比存在正相关（r=0.63,P<0.05）,RBC-C3bRR和CD4+细胞百分比存在负相关（r=-0.82,P<0.01）。结论：毛细支气管炎患儿存在T淋巴细胞、红细胞免疫功能障碍,可能在毛细支气管炎的发病机制中起到一定作用。     

恶性肿瘤患儿红细胞免疫功能的检测

目的探讨恶性肿瘤患儿红细胞免疫功能的变化。方法用花环试验检测恶性肿瘤患儿红细胞免疫功能。结果与正常儿童或良性肿瘤患儿相比,恶性肿瘤患儿RBC-C3b受体花环率及促进率显著降低(P<0.01);RBCIC花环率及RBC-C3b受体花环抑制率显著升高(P<0.01);4项肿瘤红细胞花环试验指标均显著降低(P<0.05或P<0.01)。结论恶性肿瘤患儿红细胞免疫功能是低下的,红细胞免疫功能的检测对于探讨小儿恶性肿瘤的发病机理和治疗措施具有一定的意义。     

小儿恶性淋巴瘤病理学、免疫学、细胞遗传学、超微病理学的临床研究

对35例小儿恶性淋巴瘤（ML）经病理学、免疫学、细胞遗传学及超微病理学四个方面进行研究，旨在了解其间的相互联系及其临床意义。结果表明ML免疫分型呈多样化改变，免疫分型与病理类型的恶性程度呈正相关。淋巴结染色体核型异常率高达100％，霍奇金瘤的染色体核型变化较非霍奇金淋巴瘤复杂，并与病理类型有一定相关性。15例ML同时进行了病理及电镜分型诊断，病理亚型诊断答合率80％，电镜亚型诊断符合率93．3％。提示ML是一组高度异质性恶性肿瘤，上述四方面的改变与肿瘤细胞分化密切相关，在病理分型的基础上结合电镜检查，可提高ML各亚型分类的准确性。     

当归多糖增强放射损伤小鼠胸腺细胞增殖及红细胞C3b受体粘附功能的实验研究

目的：进一步探讨当归多糖(Angelica polysaccharide, AP)的药用价值。方法：检测正常对照组、放射对照组及放射+当归多糖治疗组3组的刀豆蛋白A(ConA)诱导的胸腺细胞增殖反应和红细胞C3b受体花环率。结果：放射对照组胸腺细胞OD值和红细胞C3b受体花环率［(0.24±0.01),(16.46±0.76)%］明显低于正常对照组［(0.35±0.01),(22.30±1.26)%］,而放射+当归多糖治疗组的胸腺细胞OD值和红细胞C3b受体花环率［(0.31±0.01),(21.07±1.22%)］显著高于放射对照组［(0.24±0.01),(16.46±0.76)%］,P<0.01,有统计学意义。结论：当归多糖能明显增强放射损伤小鼠的胸腺细胞增殖和红细胞C3b受体免疫粘附功能。     

Pulmonary involvement in pediatric lymphoma

Background The prevalence of pulmonary lymphoma in the pediatric age group is not documented in the literature.Objective This study was designed to assess the prevalence of pulmonary parenchymal lymphoma in children with Hodgkin disease (HD), non-Hodgkin lymphoma (NHL) and post-transplant lymphoproliferative disorder (PTLD).Materials and methods A 10-year retrospective analysis of 161 lymphoma patients (62 girls and 99 boys), mean age of 12.4 years, was performed. The definition of pulmonary lymphoma excluded those with isolated pleural disease and/or mediastinal adenopathy.Results Eighty-two patients had HD, 65 had NHL, and 14 had PTLD. Overall prevalence of pulmonary parenchymal involvement was 13% (21/161), including 12% of patients with HD, 10% of patients with NHL, and 29% of patients with PTLD. CT findings included: pulmonary nodules (90%) or mass (38%); interstitial (9%) or alveolar (9%) disease; cavitation (9%); and pleural based mass (9%).Conclusions Pulmonary parenchymal disease in our pediatric lymphoma population was more prevalent than expected (13%). This is significant for patient management. New pulmonary lesions in patients with known lymphoma should be regarded with suspicion. In the setting of immune suppression, pulmonary lesions treated as infection may actually represent lymphoma. Expeditious biopsy of lesions failing to respond promptly to antibiotic therapy should be considered.     

Identification of a secretory IgA receptor on breast-milk macrophages: evidence for specific activation via these receptors.

Binding of secretory IgA (sIgA) to human milk macrophages was identified by rosette formation with sIgA-sensitized indicator cells and competitive inhibition binding studies with [125I]-sIgA. Macrophages formed rosettes with sIgA-sensitized sheep red blood cells that were inhibited by sIgA (87%) but not IgG. Both IgA1 and IgA2 inhibited sIgA-sensitized sheep red blood cell rosette formation. Rosette formation was completely inhibited by galactose, partially inhibited by asialofetuin, and unaffected by mannose. [125I]-labeled sIgA binding to macrophages reached a plateau after 60 min, was dependent on the number of macrophages in culture, and was specifically inhibited by unlabeled sIgA. Incubation of macrophage monolayers with increasing concentrations of sIgA-anti-IgA immune complexes resulted in a progressive increase in the oxidative burst and increased secretion of prostaglandins. These studies indicate that human milk macrophages have a receptor for sIgA and that activation of these macrophages may occur via these receptors.     

Serum levels and differential expression of CD44 in childhood leukemia and malignant lymphoma: Correlation with prognostic criteria and survival

BACKGROUND: The CD44, a cell surface proteoglycan, participates in a variety of function including tumor dissemination and metastasis. However, there are no available data on the prognostic significance of CD44 expression of tumor tissue correlated with serum sCD44 level in childhood leukemias and lymphomas. METHODS: Serum levels and leukemic cell tumor tissue expression of CD44 were detected in 54 children with acute leukemia and malignant lymphoma. Serum samples were obtained from all patients before treatment and during remission. Twelve age-matched healthy children were included as a control group. RESULTS: The serum CD44 levels were significantly higher in patients with Hodgkin's disease (HD), non-Hodgkin's lymphoma (NHL), Burkitt's lymphoma (BL) and acute lymphoblastic leukemia (ALL) than those in the control group. The median values were 1627.0, 1336.0, 1318.5, 1730.4, 902.7 ng/mL, respectively, and P<0.001, P<0.01, P<0.01, P<0.05 in comparisons, respectively. However, there was no significant difference between acute myeloid leukemia (AML) and the control group (median values: 900.3 and 902.7 ng/mL, respectively, P>0.05). Serum sCD44 levels significantly declined in HD, NHL and ALL patients who were in complete remission (median values: 684.0, 573.8 and 1101.1 ng/mL, respectively, P<0.05 in each comparison). Patients with HD had higher levels of serum sCD44 and correlated well with higher erythrocyte sedimentation rate (ESR), B-symptoms and advanced-stage disease (P<0.05, P<0.05 and P<0.01, respectively). Expression of CD44 was significantly high in patients with HD and NHL who were in advanced stages of disease. High serum CD44 level was also associated with high tumor tissue expression of CD44 in patients with HD and BL. In addition, patients with higher levels of serum sCD44, had a poorer outcome and survival than those with lower sCD44 levels in HD and NHL groups. CONCLUSIONS: A high serum sCD44 level and/or tumor tissue expression at diagnosis is associated with poor prognostic criteria and/or unfavorable outcome in childhood leukemias and lymphomas.     

新生儿和产妇红细胞免疫功能相关性分析

目的：了解兰州地区新生儿与其母亲的红细胞免疫功能状态及其关系,同时观察各种产科因素对新生儿红细胞免疫功能的影响。方法：采用细胞酵母花环法测定104例新生儿及其母亲的红细胞C3b受体花环率(RBC-C3bRR) 和红细胞免疫复合物受体花环率(RBC-ICR)。结果：①新生儿与其母亲比较,新生儿的RBC-C3bRR和RBC-ICR均高于产妇,差异有显著性,P<0.05。②经母婴配对分析,产妇与新生儿的RBC-C3bRR无明显相关性,P>0.05。而产妇与新生儿的RBC-ICR具有相关性且呈正相关,P<0.05。③新生儿的RBC-C3bRR和RBC-ICR与羊水、胎盘、脐带、分娩方式、产妇贫血、妊娠高血压综合征等因素无明显相关性,P>0.05。结论：新生儿的红细胞免疫功能已经相对成熟,产妇与新生儿的红细胞免疫功能具有一定相关性,羊水、胎盘、脐带、分娩方式等因素对新生儿的红细胞免疫功能无明显影响。［中国当代儿科杂志,2007,9（1）：19-21］