儿童川崎病急性期淋巴细胞亚群的变化与意义

目的：观察川崎病儿童急性期外周血淋巴细胞亚群的变化，以探讨儿童川崎病的发病机制。方法：选择在本院最终确诊为川崎病的219例患儿作回顾性分析，106例健康体检儿童作为对照组，应用流式细胞术检测川崎病患儿治疗前及健康对照组儿童外周血淋巴细胞亚群CD3＋细胞、CD3＋CD4＋细胞、CD3＋CD8＋细胞、CD16＋CD56＋细胞、CD19＋细胞的百分率以及CD4＋/CD8＋的比值。结果：与健康对照组相比，川崎病患儿外周血CD19＋细胞的百分率、CD4＋/CD8＋比值均明显升高（P〈0.01）、而CD3＋CD8＋细胞、CD16＋CD56＋细胞的百分率则明显下降（P〈0.01），但CD3＋CD4＋细胞百分率并无明显改变（P=0.24）；以本院淋巴细胞亚群的正常参考值为基准，川崎病儿童组急性期CD19＋细胞升高的比例极高，为90.9%（199/219），而在健康对照组中仅仅为10.4%（11/106），两组比较差异有统计学意义（P〈0.01）。结论：川崎病儿童急性期存在显著的免疫学紊乱，CD19＋细胞的升高、CD3＋CD8＋细胞和CD16＋CD56＋细胞的下降可能均参与了川崎病的发病，而且这些淋巴细胞亚群的检测在诊断川崎病时，不失为一个无创且较简便的基于免疫学角度去评价患儿疾病状态的方法。

Changes of Lymphocyte Subpopulation and Its Significance in the Children with Kawasaki Disease During Acute Phase

Objective：To investigate the change and significance of lymphocyte subpopulation in the children with kawasaki disease（KD） during acute phase. Method：Two hundred and nineteen patients diagnosed as KD in the hospital were analyzed retrospectively,106 healthy children were chosen as control. Flow cytometric analysis was employed to detect the percentage of lymphocyte subpopulation（including CD3＋cells、CD3＋CD4＋cells、CD3＋CD8＋cells、CD16＋CD56＋cells、CD19＋cells）and CD4＋/CD8＋ratio in the KD patients before treatment and in the healthy children. Result：Compared with healthy control,the percentage of CD19＋cells、and CD4＋/CD8＋ratio in patients with KD increased significantly（P〈0.01）,and the percentage of CD3＋CD8＋cells、CD16＋CD56＋cells decreased significantly（P〈0.01）,but there were not any significant change about the percentage of CD3＋CD4＋cells（P=0.24）. Based on the standard value of lymphocyte subpopulation in the hospital,there were 199 KD patients who had increased CD19＋cells percentage ,but only 11 children out of the healthy group had higher CD19＋cells percentage（P〈0.01）. Conclusion：There are evident immunity disturbances during the acute phase of KD,these changes including decreased percentage of CD3＋CD8＋cells,CD16＋CD56＋cells and elevated CD19＋cells percentage might take some role in the KD development,and detecting the percentage of lymphocyte subpopulation maybe helpful in the diagnosis of KD from one immunological view.