传染性单核细胞增多症患儿T淋巴细胞亚群变化的意义及不同干预措施的影响

[Significance of changes of T lymphocytes subsets in children with infectious mononucleosis and the effects of different interventions].

作者信息

Chen Zhuang-gui, Li Ming, Ji Jing-zhi, Chen Hong, Chen Yan-feng, Chen Fen-hua

机构信息

Department of Pediatrics, The Third Hospital Affiliated to Sun Yat-sen University, Guangzhou 510630, China.

出版信息

Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2009 Apr;23(2):118-20.

PMID:20104753

Abstract

OBJECTIVE

To investigate changes of T lymphocytes subsets in children with infectious mononucleosis (IM) and the effects of different interventions.

METHODS

Forty-eight children with IM were enrolled, 28 cases were assigned to the group treated with intravenous immunoglobulin (IVIG) 400 mg/(kg x d) for 5 continuous days or IVIG 1 g/(kg x d) for 2 continuous days, the remaining 20 cases were treated with ganciclovir (GCV) 5-10 mg/(kg x d) for 5 consecutive days. All these children were given general supportive therapies. Twenty healthy children from healthcare clinic serviced as control group.

RESULTS

CD4 (%), CD8 (%) and the CD4/CD8 ratio in healthy control group were (34.12 +/- 3.53)%, (26.22 +/- 4.43)% and (1.41 +/- 0.3), in IVIG group were (24.2 +/- 4.3)%, (36.4 +/- 6.8)% and (0.72 +/- 0.12), and in GCV group were (23.7 +/- 5.1)%, (37.3 +/- 7.8)% and (0.67 +/- 0.13), respectively. CD4 (%), CD8 (%) and the ratio CD4/CD8 in the control group were significantly different from those in both groups with IM (P < 0.05). Compared with pre-treatment levels, the 28 cases treated with IVIG had significant improvement, the CD4 (%) increased, CD8 (%) decreased and the ratio of CD4/CD8 increased after treatment (P < 0.05). However, 20 cases in GCV treatment group made less changes (P > 0.05) . Meanwhile, the clinical symptoms and signs in the IVIG group were improved faster than that in the GCV group (P < 0.05). The rate of remission in IVIG group was 88.7% vs. 59.2% of GCV group (P < 0.05); the hospital days in IVIG group were (9.2 +/- 4.3) days vs. (13.8 +/- 5.1) days in the GCV (P < 0.05).

CONCLUSION

It is indicated that the subsets of T lymphocytes in peripheral blood are obviously abnormal in children with IM caused by EBV infection in acute phase. IVIG can regulate the immunological derangements of T lymphocytes subsets, on which anti-viral therapy alone may have little impact.

摘要

目的

探讨传染性单核细胞增多症（IM）患儿T淋巴细胞亚群的变化及不同干预措施的效果。

方法

选取48例IM患儿，其中28例给予静脉注射免疫球蛋白（IVIG）400mg/（kg·d），连续5天或IVIG 1g/（kg·d），连续2天；其余20例给予更昔洛韦（GCV）5 - 10mg/（kg·d），连续5天。所有患儿均给予一般支持治疗。选取20名来自保健门诊的健康儿童作为对照组。

结果

健康对照组CD4（%）、CD8（%）及CD4/CD8比值分别为（34.12±3.53）%、（26.22±4.43）%和（1.41±0.3）；IVIG组分别为（24.2±4.3）%、（36.4±6.8）%和（0.72±0.12）；GCV组分别为（23.7±5.1）%、（37.3±7.8）%和（0.67±0.13）。对照组CD4（%）、CD8（%）及CD4/CD8比值与两组IM患儿均有显著差异（P<0.05）。与治疗前水平相比，28例接受IVIG治疗的患儿有显著改善，治疗后CD4（%）升高，CD8（%）降低，CD4/CD8比值升高（P<0.05）。然而，GCV治疗组的20例患儿变化较小（P>0.05）。同时，IVIG组的临床症状和体征改善较GCV组更快（P<0.05）。IVIG组缓解率为88.7%，GCV组为59.2%（P<0.05）；IVIG组住院天数为（9.2±4.3）天，GCV组为（13.8±5.1）天（P<0.05）。