甲型H1N1流感患儿Th细胞亚群的动态变化及临床意义

目的检测甲型H1N1流感患儿Th细胞亚群的动态变化,探讨甲型H1N1流感的发病机制,并评价患儿的免疫状况及与疾病严重程度和预后的关系。方法总结19例甲型H1N1流感患儿Th细胞亚群动态变化,选择21例健康儿童作为健康对照组。采用流式细胞仪计数INF-γ＋细胞占CD3＋CD8-T细胞百分比（Th1%）和IL-4＋占CD3＋CD8-T细胞百分比（Th2%）,并计算Th1与Th2的比值。结果 19例甲型H1N1流感患儿中,存活15例（78.9%）,死亡4例（21.1%）。健康对照组、存活组和死亡组三组儿童性别、年龄无显著性差异;入院时,甲型H1N1流感患儿存活组和死亡组Th1%、Th2%和Th1/Th2分别为6.65%（0.62%～25.30%）vs.7.26%（4.66%～14.03%）、1.40%（0.31%～5.41%）vs.1.69%（1.52%～2.42%）、6.15%（2.0%～14.46%）和3.84%（3.03%～7.67%）,Th1%较健康对照组无明显改变,Th2%显著升高、Th1/Th2显著下降（P均〈0.01）;存活的甲型H1N1流感患儿Th1%逐渐升高,Th1/Th2比例有可逆性下降,最终升高;而同期死亡者Th1/Th2比例不可逆性下降,直至死亡,较存活组和健康组有显著性差异（P〈0.05）。结论甲型H1N1流感急性期为Th2细胞占优势型,存在免疫抑制;Th1/Th2的平衡可以影响机体的免疫状态,动态监测还可对疾病的程度和预后做出判断。

The study of T-helper cell subpopulation dynamic change and clinical research for children with influenza A (H1N1) virus infection

Objective To monitor the dynamic changes of Th cell in influenza A (H1N1) virus infection children and study the pathogenesis of the disease and evaluate their immunological condition,relationship between severity of illness and prognosis.Methods Th1%,Th2% and Th1/Th2 in peripheral blood were detected dynamically by Flow Cytometry in 19 children with H1N1 infection who were hospitalized in affiliated hospital of capital institute of pediatrics.Twenty-one healthy children were selected as healthy control gro...