多种微量元素佐治小儿反复呼吸道感染的疗效及免疫学观察

目的　了解多种微量元素对小儿反复呼吸道感染 (RRI)的疗效及对T细胞亚群的影响。方法　12 0例RRI患儿随机分成治疗组和对照组 ,治疗组加用多种微量元素 ,用碱性磷酸酶 抗碱性磷酸酶桥联标志法测治疗组治疗前后T细胞亚群改变。结果　治疗组患儿血清CD4 /CD8比值增加 ,有效率显著高于对照组患儿。结论　多种微量元素对RRI具有较好的疗效。     

多种微量元素佐治反复呼吸道感染患儿疗效及免疫学观察

反复呼吸道感染 (recurrentrespiratoryinfection ,RRI)是儿科常见病、多发病 ,其发生与T细胞亚群的改变及血清锌、硒等微量元素浓度降低有关[1]。 1996年 4月～ 1998年 12月我们用含有多种微量元素的锌硒宝片佐治RRI ,并观察其免疫学变化 ,现报道如下。临床资料一、病例选择     

反复呼吸道感染儿血清微量元素谱,外周血T细胞亚群检测及其意义

研究目的探讨反复呼吸道感染（ＲＲＴＩ）患儿血清微量元素含量，外周血Ｔ细胞亚群的变化及其意义。研究方法ＲＲＴＩ患儿９２例，男５８例，女３４例。４２名健康儿童为对照组。取清晨（７时～９时）空腹静脉血（肝素抗凝）（３～５）ｍｌ。血清微量元素谱测定采用Ｓｐｅｃｔｒａｓｐａｎ－Ｖ型三电极等离子原子发射直读光谱仪（ＤＣＰ－ＡＥＳ），同时测定１２种微量元素含量，如锌（７ｎ）、锰（Ｍｎ）、铝（Ａｌ）、镉（Ｃｄ）、铁（Ｆｅ）、铅（Ｐｂ）、铜（Ｃｕ）、镍（Ｎｉ）、钛（Ｔｉ）、钴（Ｃｏ）、锂（Ｌｉ）、铬（Ｃｒ）等。Ｔ细胞正群测定采用抗人单克隆抗体致敏红细胞花环法，Ｔ细胞增殖功能测定采用３Ｈ－ＴｄＲ掺入法。结果ＲＲＴＩ患儿血清微量元素Ｚｎ、Ｐｂ、Ｎｉ、Ｃｏ、Ｌｉ、Ｆｅ、Ｔｉ明显低于正常对照组。外周血Ｔ细胞亚群、细胞百分率、比值及Ｔ细胞增殖功能显著低于正常对照组，血清ＩｇＧ也低于对照组。     

斯奇康治疗小儿反复呼吸道感染疗效观察

小儿反复呼吸道感染(RRTI)，虽非疑难病症，但因其反复性，对患儿各系统造成不良影响，给社会、家庭带来许多的痛苦和负担，近两年来，我院应用斯奇康治疗此病取得了良好的效果，现报告如下。     

乌体林斯治疗反复呼吸道感染患儿前后血清T细胞亚群的变化

目的探讨乌体林斯治疗反复呼吸道感染(RRI)患儿前后T细胞亚群的变化。方法对RRI患儿40例予乌体林斯肌肉注射1.72μg/次,1次/周,共用10次。分别于RRI发作期、缓解期、治疗后对患儿血清CD8、CD3、CD4、CD4/CD8进行动态监测,并与正常对照组比较。结果治疗后血清CD8下降,CD3、CD4、CD4/CD8增高,与发作期和缓解期比较有显著性差异(P均<0.01),与正常对照组比较差异无显著性(P均>0.05)。结论乌体林斯是治疗RRI的安全有效的调节剂。     

补充铁、锌对反复呼吸道感染患儿血清其它微量元素的影响

等离子体原子发射直读光谱法（ＤＣＰ－ＡＥＳ）检测８４例反复呼吸道感染（ＲＲＩ）患儿血清锌、锰、铝、镉、铁、铅、铜、镍、钛、钴、锂和铬的水平，并对其中密切合作的３７例血锌和／或铁水平降低者进行了补充富马酸亚铁和／或硫酸锌治疗后的纵向观察。结果表明治疗前ＲＲＩ组血清锌、铁、铅、镍、钛、钴、锂均值显著降低，锰、铝、镉、铜、铬均值无明显变化；治疗２个月后，ＲＲＩ患儿随临床症状明显改善，血清锌、铁、钛、钴、锂水平较前明显升高，铝、镉、铜水平下降，锰、镍、铅水平则无显著变化。提示铁、锌缺乏可能在ＲＲＩ发病中占有重要地位，补充铁锌对其它元素的血清水平及分布等可能有明显影响。     

反复呼吸道感染儿外周血T细胞亚群的变化

研究目的 探讨小儿反复呼吸道感染与外周血T细胞亚群变化的关系。 研究设计 病例对照研究。 患者和其他参与者 反复呼吸道感染患儿32例,男21例,女11例。对照组为20例健康儿童,男13例,女7例。 处理方法 所有患者和参与者均于上午8时采血送检。 检测和主要结果 用OKT单克隆抗体检测了32例患儿和20例健康儿童外周血T细胞亚群。结果显示:复感儿组与对照组OKT_3的百分率分别为56.21±7.19和61.42±4.87(P<0.01),OKT_4分别为37.27±3.45和39.35±3.52(P<0.05),OKT_8分别为30.69±3.94和28.14±4.22(P<0.05),OKT_4/OKT_3分别为1.31±0.14和1.41±0.16(P<0.05)。 结论 反复呼吸道感染患儿外用血 OKT_3、OKT_4降低,OKT_3升高,OKT_4/OKT_3降低。提示该病患儿不仅细胞免疫功能低下,而且T细胞亚群比例失调。     

Prophylactic antibiotics for children with recurrent urinary tract infections

Prophylactic antibiotics for urinary tract infections are no longer routinely recommended. A large number of children must be given prophylaxis to prevent one infection and antibiotic resistance is a major concern when treating community-acquired urinary tract infections. The results of three recent significant studies are examined, with focus on the efficacy of prophylaxis, and recommendations are made.     

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??Immaturity of the immune system and exposure to infectious agents contribute to the susceptibility of RRTIs in children?? and RRTIs are usually treated with immunomodulating agents. The administration of probiotics plays a role in modulation of immune responses by various methods, including colonization resistance?? increased number and activity of natural killer cells?? release of cytokines?? and enhanced antibody response?? et al. Data show that probiotics may be bene?cial to preventing respiratory tract infections??RTIs???? reducing the number of episodes of RTIs?? diminishing the severity of infection symptoms?? and reducing duration of episodes?? antibiotic use and the number of days absent from day care/school. Probiotics appear to be a feasible way to decrease the incidence of RTIs in children??but further well-designed studies are needed to evaluate the strains?? dosing?? and frequency in the use of probiotics for RRTIs.     

Transfer factor in chronic and recurrent respiratory tract infections in children.

Five cases with abnormal sensitivity to respiratory tract infections are described. The cases showed a marked impairment in their cell mediated immunity state. Administration of a chromatographically purified transfer factor component increased the skin test sensitivity to common recall antigens. Interestingly, a similar effect in skin reactivity was observed with repeated skin tests alone, when antigen concentrations, initially high enough to cause a positive reaction, were used. Neither the administration of transfer factor nor skin testing with high antigen concentrations had an effect on blast transformation percentages. The therapy with chromatographically purified transfer factor appeared promising on the clinical condition of the patients.     

Subclinical trace element deficiency in children with undue susceptibility to infections

Serum concentrations of iron, copper, zinc and magnesium and also serum transferrin and ceruloplasmin were investigated in 28 children aged 10 months to 10 years with undue susceptibility to infections. None of the children had any classical immune defect. Seven of them had had frequent upper respiratory tract infections, 16 had suffered from frequent infections of the middle ear and five from mainly lower respiratory tract infections. Thirteen healthy children aged 9 to 18 years residing in the same area served as controls. The children with undue susceptibility to infections had significantly lower mean serum iron (p less than 0.05) and zinc (p less than 0.001) levels than the healthy controls. The mean serum concentrations of copper and magnesium and of transferrin and ceruloplasmin did not differ between the patients and controls. Children with frequent middle ear infections seemed to account for most of the differences in the serum levels of iron and zinc. An inverse correlation was observed between duration of breast feeding and serum concentration of zinc, and between weight as well as height and serum magnesium. The reasons for these changes and the possible role of trace element deficiency as a factor predisposing to or perpetuating undue susceptibility to infections in children are discussed.     

反复呼吸道感染如何选择实验室检查

儿童反复呼吸道感染是常见的临床现象,病因繁杂,寻找潜在原因是正确诊治患儿的前提。儿科医生应合理选择初始实验室筛查,根据病情进一步选择确诊性免疫检查,正确解读检测结果,科学管理患儿。