小儿传染性单核细胞增多症免疫状况动态观察

目的研究小儿传染性单核细胞增多症（IM）免疫功能动态变化，观察EB病毒（EBV）感染对免疫功能影响，为判断预后及治疗提供依据。方法应用流式细胞术对23例IM患儿急性期及恢复划外周血淋巴细胞CD3^＋、CD4^＋、CD8^＋、CD19^＋抗原进行检测．并与30例对照组健康儿童比较。结果IM患儿急性期外周血淋巴细胞CD3^＋、CD4^＋、CD8^＋、CD19^＋抗原分别为（80．74±8．51）％、（17．53±6．08）％、（57．38±14．90）％、（7．35±6．24）％。CD3^＋、CD8^＋显著高于对照组[（68．47±7．01）％、（24．10±4．65）％，P〈0．01]。CD4^＋、CD19^＋较对照组降低[（38．63±6．14）％、（19．00±5．27）％，P〈0．01]。恢复期CD8^＋降低[（34．52±12．28）％]，仍高于对照组（P〈0．01）；CD4^＋升高[（26．91±6．24）％]，仍低于对照组（P〈0．01）。结论IM患儿急性期外周血淋巴细胞亚群显著异常，恢复期机体仍处于免疫紊乱状态，CD4^＋T细胞持续低下可能需免疫调节治疗。

Dynamic Analysis of Immunity Function in Children with Infectious Mononucleosis

Objective To analyze the effect of Epstein-Barr virus （EBV） infection on immunity function in children with infectious mononucleosis （IM）. Methods Blood samples were examined for expressions of CD3^＋ , CD4^＋ , CD8^＋ , and CD19 ^＋ on lymphocytes by flow cytometry （FCM） in 23 children with IM experiencing acute and convalescent phases, and were compared with those of 30 healthy controls. Results The levels of CD3 ^ , CD4^＋, CD8^ ＋ , CD19 ^＋ expressions were （80.74 ± 8.51 ） % , （ 17.53 ± 6.08 ）% , （57.38 ± 14.90）% and （7.35 ± 6.24）% in the IM group at acute phase. The levels of CD3^＋ and CD8 ^＋ significantly increased in the IM group compared with those of the healthy controls （P 〈 0.01 ） , while the levels of CD4 ^＋ and CD19^ ＋ decreased （ P 〈0.01 ）. In comparison with the acute phase, the level of CD8 ^＋ （ 34.52 ± 12.28 ） % decreased and the level ot CD4^ ＋ （26.91 ± 6.24） % increased in the convalescent phase （ P 〈 0.01 ） Conclusion It is indicated that the subsets of lymphocytes in peripheral blood are obviously abnormal in children with IM in acute phase. The immunity disorder still exists in convalescent phase. The immunomodulation therapy may be necessary if the level of CD4 ^＋ remains lower.