病毒性肺炎患儿自然杀伤细胞亚群、T细胞亚群及血IL-2、IL-4、INF-γ变化的研究

目的 探讨病毒性肺炎患儿自然杀伤(NK)细胞亚群、T细胞亚群及血IL-2、IL-4、INF-γ的动态变化及临床意义.方法 采用流式细胞术测定32例病毒性肺炎患儿急性期(肺炎起病2?d内)、恢复期(肺炎起病5?d内)外周血NK细胞亚群、T细胞亚群,用ELISA法测定血IL-2、IL-4、INF-γ水平,用乳酸脱氢酶释放法测定NK细胞活性变化,并与30例健康对照组儿童进行比较.结果 (1) 病毒性肺炎患儿CD16+CD56+、CD16+NK细胞在急性期分别为(0.73±0.17)%、(0.39±0.2)%,恢复期分别为(1.47±0.22)%、(0.89±0.14)%;急性期与恢复期比较,恢复期CD16+CD56+、CD16+NK细胞明显升高(P<0.01),但均显著低于对照组(P<0.01).两组NK细胞亚群变化与其活性改变呈正相关.病毒性肺炎患儿CD56+NK细胞与健康儿童差异无显著性(P>0.05).(2) 与对照组相比,病毒性肺炎患儿的急性期、恢复期IL-2、IL-4均无明显改变,差异无显著性(P>0.05);急性期INF-γ无明显改变,差异无显著性(P>0.05),而恢复期INF-γ(28.10±1.38)?μg/L]明显高于急性期(22.78±1.19)?μg/L],差异有非常显著性(P<0.01).(3) 与对照组相比,病毒性肺炎患儿CD4+、CD4+/CD8+T细胞计数在急性期与恢复期均无明显改变,差异无显著性(P>0.05).病毒性肺炎急性期、恢复期CD8+T细胞均低于对照组,差异有显著性(P<0.05),但病毒性肺炎急性期、恢复期间差异无显著性(P>0.05).结论 病毒性肺炎患儿NK细胞活性降低,活性与亚群数目呈正相关;病毒性肺炎患儿抑制性T细胞功能低下.病毒性肺炎急性期NK细胞激活是多因素共同作用的结果 .

Changes of blood natural killer cell,T lymphocyte subsets,IL-2,IL-4 and INF-γ in children with viral pneumonia

Objective To observe the changes of NK cell subset (CD56+,CD16+CD56+,CD16+),T cell subset (CD4+,CD8+,CD4+/CD8+) counts and related cytokines (IL-2,IL-4,INF-γ) in children with viral pneumonia.Methods Thirty-two children with viral pneumonia in acute stage (within 2 days after pneumonia onset) and recovery phase (within the range of the third to the fifth day after pneumonia onset) were included in this study.Peripheral blood NK cell subsets and T cell substes were determined by the flow cytometry.Blood IL-2,IL-4 and INF-γ were detected by ELISA.NK cytoactivity was measured by LDH release method.Results (1) The levels of the CD16+CD56+ and CD16+NK cell counting in acute stage (0.73±0.17)% and (0.39±0.20)%] were lower than those in the recovery phase (1.47±0.22)% and (0.89±0.14)%],which showed significant difference (P<0.01),however the level of CD16+CD56+ and CD16+NK cell counting either in acute stage or recovery phase was significantly lower than those of healthy control group (P<0.01).The sub population counting and NK cell activity was directly correlated.CD56+NK cell counting showed no significant difference between viral pneumonia group and control group (P>0.05).(2) There was no significant difference in blood IL-2 and IL-4 level between viral pneumonia group (either in acute stage or recovery phase) and the control group (P>0.05).As compared with that of the control group,blood INF-γ level of viral pneumonia group showed no significant change in acute stage (P>0.05),but INF-γ level in recovery phase (28.10±1.38)?μg/L] was higher than that in acute stage (22.78±1.19)?μg/L] and there was significant difference (P<0.01).(3) As compared with that of the control group,CD4+ and CD4+/CD8+T cell counting of viral pneumonia group showed no obvious changes either in acute stage or recovery phase (P>0.05).CD8+T cell counting of both two stages were much lower than that of the control group (P<0.05),but there was no significant difference between the two stages (P>0.05).Conclusion The NK cell activity in children with viral pneumonia decline obviously,which might be related to the changes of T cell subsets;the activity of suppressor T cell was depressed in patients with viral pneumonia.There are maybe many factors involved in the NK cell activation.