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儿童反复呼吸道感染——免疫检查分析

Recurrent respiratory tract infections in children - analysis of immunological examinations.

作者信息

Raniszewska Agata, Górska Elżbieta, Kotuła Iwona, Stelmaszczyk-Emmel Anna, Popko Katarzyna, Ciepiela Olga

机构信息

Students' Scientific Group at the Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Medical University of Warsaw, Poland.

Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Medical University of Warsaw, Poland.

出版信息

Cent Eur J Immunol. 2015;40(2):167-73. doi: 10.5114/ceji.2015.52830. Epub 2015 Aug 3.

Abstract

BACKGROUND

Paediatric respiratory tract infections are among the most common reasons for preschool and school absences and visits to physicians. The disease mainly involves the upper respiratory tract and is associated with fever, cough, sore throat, and running nose. Children with recurrent respiratory infections (RRI), which are defined as more than six serious diseases a year, are a difficult diagnostic challenge. The aim of this study was to assess immunological deviations in laboratory tests performed in children with RRI.

MATERIAL AND METHODS

In the retrospective study 25 children suffering from recurrent respiratory tract infection, aged 4.1 ±2.3 years, 13 boys and 12 girls, were involved. For all children chemiluminescence of granulocytes and immunophenotyping of lymphocytes from peripheral blood were examined. An immunophenotype of peripheral blood lymphocytes involved evaluation of T cell, B cells, and NK cells, examined with flow cytometry.

RESULTS

Eleven of the studied children had decreased chemiluminescent response to stimulants, normal response was found for nine children, and five children had an increased result of the test. Five of the 25 children had decreased B cells number, and five had decreased number of T cells including decrease of CD4, as well as CD8 positive cells. Children with decreased chemiluminescence had more frequent neutropaenia than children with normal or increased chemiluminescent response, p < 0.05 (exact Fisher test).

CONCLUSIONS

Recurrent respiratory tract infection could be associated with improper neutrophils response to pathogens, and immunological examination should be performed to find the reason for the increased number of infections in a year.

摘要

背景

小儿呼吸道感染是学龄前儿童和学龄儿童缺课及就医的最常见原因之一。该疾病主要累及上呼吸道,伴有发热、咳嗽、喉咙痛和流鼻涕。反复呼吸道感染(RRI)的儿童,即每年患六种以上严重疾病的儿童,是一个诊断难题。本研究的目的是评估反复呼吸道感染儿童实验室检查中的免疫偏差。

材料与方法

在这项回顾性研究中,纳入了25名反复呼吸道感染的儿童,年龄为4.1±2.3岁,其中13名男孩和12名女孩。对所有儿童进行粒细胞化学发光和外周血淋巴细胞免疫表型分析。外周血淋巴细胞免疫表型分析包括用流式细胞术检测T细胞、B细胞和NK细胞。

结果

11名研究儿童对刺激物的化学发光反应降低,9名儿童反应正常,5名儿童检测结果升高。25名儿童中有5名B细胞数量减少,5名T细胞数量减少,包括CD4和CD8阳性细胞减少。化学发光降低的儿童比化学发光反应正常或升高的儿童中性粒细胞减少更为频繁,p<0.05(确切概率法)。

结论

反复呼吸道感染可能与中性粒细胞对病原体的反应不当有关,应进行免疫学检查以找出一年中感染次数增加的原因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b429/4637391/ac09ce481dc3/CEJI-40-25453-g001.jpg

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