Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China.
Front Cell Infect Microbiol. 2023 May 12;13:1173362. doi: 10.3389/fcimb.2023.1173362. eCollection 2023.
Children with influenza B virus infection have a higher susceptibility and higher severity of illness. The activation and disorder of immune function play an important role in the severity of influenza virus infection. This study aims to investigate whether early lymphocyte count and cytokines can provide predictive value for the progression in children with influenza B virus pneumonia.
A retrospective cohort study was conducted to analyze the clinical data of children with influenza B virus pneumonia from December 1, 2021, to March 31, 2022, in the National Children's Regional Medical Center (Shengjing Hospital of China Medical University). According to the severity of the disease, the children were divided into a mild group and a severe group, and the clinical characteristics, routine laboratory examination, lymphocyte subsets, and cytokines were compared.
A total of 93 children with influenza B virus pneumonia were enrolled, including 70 cases in the mild group and 23 cases in the severe group. Univariate analysis showed that drowsiness, dyspnea, white blood cell (WBC), lymphocytes, monocytes, procalcitonin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase-MB (CK-MB), lactate dehydrogenase (LDH), fibrinogen (FIB), Immunoglobulin M (IgM), lung consolidation, total T cell count, CD4 T cell count, CD8 T cell count, NK cell count, NK cell % and B cell % had statistical differences between the mild and severe groups (<0.05). In multivariate logistic regression analysis, reduced ALT (OR = 1.016), FIB (OR = 0.233), CD8 T cell count (OR = 0.993) and NK cell count (OR = 0.987) were independently associated with the development of severe influenza B virus pneumonia.
The levels of T lymphocytes and NK cells were related to the progression of influenza B virus pneumonia in children, and the reduction of CD8 T cell count and NK cell count can be used as independent risk factors for predicting the severity of influenza B virus pneumonia.
儿童感染乙型流感病毒后易感性更高，疾病严重程度更高。免疫功能的激活和紊乱在流感病毒感染的严重程度中起重要作用。本研究旨在探讨早期淋巴细胞计数和细胞因子是否能为乙型流感病毒肺炎患儿的病情进展提供预测价值。
采用回顾性队列研究方法，分析 2021 年 12 月 1 日至 2022 年 3 月 31 日在中国医科大学附属盛京医院收治的乙型流感病毒肺炎患儿的临床资料。根据疾病严重程度，患儿分为轻症组和重症组，比较两组临床特征、常规实验室检查、淋巴细胞亚群和细胞因子。
共纳入 93 例乙型流感病毒肺炎患儿，轻症组 70 例，重症组 23 例。单因素分析显示，嗜睡、呼吸困难、白细胞（WBC）、淋巴细胞、单核细胞、降钙素原、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、肌酸激酶同工酶-MB（CK-MB）、乳酸脱氢酶（LDH）、纤维蛋白原（FIB）、免疫球蛋白 M（IgM）、肺部实变、总 T 细胞计数、CD4 T 细胞计数、CD8 T 细胞计数、自然杀伤（NK）细胞计数、NK 细胞%和 B 细胞%在轻症组和重症组之间有统计学差异（<0.05）。多因素 logistic 回归分析显示，ALT 降低（OR=1.016）、FIB 降低（OR=0.233）、CD8 T 细胞计数降低（OR=0.993）和 NK 细胞计数降低（OR=0.987）与重症乙型流感病毒肺炎的发生独立相关。
T 淋巴细胞和 NK 细胞水平与儿童乙型流感病毒肺炎的进展有关，CD8 T 细胞计数和 NK 细胞计数的降低可作为预测乙型流感病毒肺炎严重程度的独立危险因素。
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