儿童传染性单核细胞增多症临床特征及T细胞亚群分析Analysis of clinical features and T lymphocyte subset in children with infectious mononucleosis
张坤龙;王会平;刘亢亢;汪燕;王宁玲;
摘要(Abstract)：
目的探讨儿童传染性单核细胞增多症(IM)的临床特征和T细胞亚群变化规律,分析其临床意义。方法回顾性分析2015年1月-2016年12月收治的59例IM患儿的临床资料,比较患儿初诊及治疗后的临床特征和实验室检测指标。结果初诊患儿临床表现以发热(93.2%)、淋巴结肿大(62.7%)和咽峡炎(52.5%)多见;实验室检查以外周血WBC>10>10~9/L(84.7%)、外周血异型淋巴细胞>10%(81.3%)和ALT升高(52.5%)多见;与初诊时比较,治疗后淋巴结肿大阳性率差异无显著性(P>0.05),其他项目差异均具有显著性(P<0.05)。初诊患儿DNT细胞、CD3~+T细胞、CD3~+CD8~+T细胞百分比均显著高于对照组(P<0.01),CD3~+CD4~+T细胞百分比显著低于对照组(P<0.01)。治疗后患儿DNT细胞、CD3~+T细胞、CD3~+CD4~+T细胞、CD3~+CD8~+T细胞与正常对照组相比差异无显著性(P>0.05)。结论 IM起病时症状多样,存在明显的免疫失衡,监测患儿不同时期临床特点及T细胞亚群变化,能够为IM患儿临床免疫治疗提供理论依据。
关键词(KeyWords)： 传染性单核细胞增多症,儿童;T细胞亚群
基金项目(Foundation):
作者(Author): 张坤龙;王会平;刘亢亢;汪燕;王宁玲;
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参考文献(References)：
- 1.中华医学会儿科学分会感染学组,全国儿童EB病毒感染协作组.儿童主要非肿瘤性EB病毒感染相关疾病的诊断和治疗原则建议.中华儿科杂志,2016,54:563-568.
- 2.Womack J,Jimenez M.Common questions about infectious mononucleosis.Am Fam Physician,2015,91:372-376.
- 3.Dunmire SK,Hogquist KA,Balfour HH.Infectious Mononucleosis.Curr Top Microbiol Immunol,2015,390:211-240.
- 4.González Saldana N,Monroy Colin VA,Pina Ruiz G,et al.Clinical and laboratory characteristics of infectious mononucleosis by EpsteinBarr virus in Mexican children.BMC Res Notes,2012,20;361-362.
- 5.Odame J,Robinson J,Khodai-Booran N,et al.Correlates of illness severity in infectious mononucleosis.Can J Infect Dis Med Microbiol,2014,25:277-280.
- 6.Biggs TC.Use of the absolute lymphocyte count in the diagnosis of infectious mononucleosis.Clin Otolaryngol,2011.36:515-516.
- 7.Cao P,Zhang M,Wang W,et al.Fluorescence in situ hybridization is superior for monitoring Epstein Barr viral load in infectious mononucleosis patients.BMC Infect Dis,2017,17:323.
- 8.Passos LS,Villani FN,Magalhaes LM,et.al.Blocking of CDld Decreases Trypanosoma cruzi-Induced Activation of CD4-CD8-T Cells and Modulates the Inflammatory Response in Patients With Chagas Heart Disease.J Infect Dis,2016,214:935-944.
- 9.Ahmed,RK,Poiret,T,Amhati,A,et al.TCR+CD4~-CD8~-T cells in Antigen-specific MHC Class I-restricted T-cell Responses after allogeneic hematopoietic stem cell transplantation.J Immunother,2014,37:416425.
- 10.李稳霞,张栋,李照等.CD4-CD8-双阴性T细胞在B细胞介导免疫反应中的作用.免疫学杂志,2015,31:171-175.