巨细胞病毒感染患儿细胞免疫应答反应及临床意义

目的:探讨巨细胞病毒(CMV)感染患儿细胞免疫应答反应及临床意义。方法:选择2015年6月至2019年5月在本院确诊的97例CMV感染患儿,根据其有无临床症状分为症状组和无症状组,选择同期健康体检婴儿48例为对照组。采用RT-PCR反应检测所有患儿尿液标本中CMV DNA载量;采用ELISA法检测所有纳入研究对象IL-6、IL-10、TNF-α水平,流式细胞仪检测外周血T淋巴细胞亚群;采用Pearson相关性分析外周血T淋巴细胞亚群与IL-6、IL-10、TNF-α水平和CMV DNA载量之间的相关性。结果:与对照组相比,CMV感染患儿有症状组和无症状组外周血CD3+T、CD3+CD4+T和CD4+/CD8+细胞水平均明显降低(P<0.05),血清IL-6、IL-10和TNF-α水平明显升高(P<0.05),有症状组外周血CD3+CD8+T细胞水平明显升高(P<0.05);与无症状组相比,CMV感染患儿有症状组患儿尿液中CMV DNA载量明显升高(P<0.05),外周血CD3+T、CD3+CD4+T和CD4+/CD8+水平均明显降低(P<0.05),IL-6、IL-10和TNF-α、CD3+CD8+T水平均明显升高(P<0.05);Pearson相关性分析显示,CMV感染患儿外周血CD3+T、CD3+CD4+T和CD4+/CD8+细胞水平均与CMV DNA载量、IL-6、IL-10和TNF-α水平呈显著的负相关(P<0.05),CD3+CD8+T细胞水平均与CMV DNA载量、IL-6、IL-10和TNF-α水平呈显著的正相关(P<0.05)。结论:CMV感染患儿的外周血CD3+T、CD3+CD4+T和CD4+/CD8+水平明显下降,且其下降水平与CMV DNA病毒载量显著相关。

Cellular immune response in children with cytomegalovirus infection and its clinical significance

Objective:To explore cellular immune response in children with cytomegalovirus(CMV)infection and its clinical significance.Methods:A total of 97 children who were confirmed with CMV infection in the hospital from June 2015 to May 2019 were enrolled.According to presence or absence of clinical symptoms,they were divided into symptomatic group and asymptomatic group.A total of 48 healthy infants who underwent physical examination were enrolled as control group.CMV DNA load in urine samples of all children was detected by fluorescent quantitative PCR.The levels of IL-6,IL-10 and TNF-αin all subjects were detected by ELISA.T lymphocyte subsets in peripheral blood were detected by flow cytometry.Pearson correlation analysis was applied to analyze correlation between T lymphocyte subsets in peripheral blood and serum IL-6,IL-10,TNF-αlevels,CMV DNA load.Results:Compared with control group,levels of CD3+T,CD3+CD4+T and CD4+/CD8+cells in peripheral blood were significantly decreased in symptomatic group and asymptomatic group(P<0.05),while levels of serum IL-6,IL-10 and TNF-αwere significantly increased(P<0.05),and level of CD3+CD8+cells in peripheral blood was significantly increased in symptomatic group(P<0.05).Compared with asymptomatic group,CMV DNA load in urine was significantly increased in symptomatic group(P<0.05),while levels of CD3+T,CD3+CD4+T and CD4+/CD8+in peripheral blood were significantly decreased(P<0.05),and levels of serum IL-6,IL-10,TNF-αand CD3+CD8+T were significantly increased(P<0.05).Pearson correlation analysis showed that levels of CD3+T,CD3+CD4+T and CD4+/CD8+cells in peripheral blood of CMV infection children were significantly negatively correlated with CMV DNA load,levels of serum IL-6,IL-10 and TNF-α(P<0.05),while levels of CD3+CD8+cells were significantly positively correlated with them(P<0.05).Conclusion:The levels of CD3+T,CD3+CD4+T and CD4+/CD8+cells in peripheral blood are significantly decreased in children with CMV infection.And their decrease levels are significantly correlated with CMV DNA viral load.