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麻疹中的免疫麻痹与预后

Immunoparesis and outcome in measles.

作者信息

Coovadia H M, Wesley A, Brain P, Henderson L G, Hallett A F, Vos G H

出版信息

Lancet. 1977 Mar 19;1(8012):619-21. doi: 10.1016/s0140-6736(77)92056-6.

Abstract

In five children with measles who subsequently died and in one with measles in whom chronic bronchopneumonia developed (group A), immunosuppression was more pronounced during the acute rash (i.e., 3-20 days before death) than in six children with measles who recovered (group B). The absolute total lymphocyte-count (T and B cells) was significantly lower in group A. Mean serum-C3 was also lower in group A than in group B. There were no significant differences between the two groups for other complement factors or for serum-immunoglobulins. The mean phytohaemagglutinin stimulation index (S.I.) for lymphocytes from patients in group A resembled that in group B, although the S.I. in both groups was significantly lower than that in healthy controls. S.I.S were lowest in two patients who died. Counts of total white cells, neutrophils, null cells, and those with both B and T cell markers were not significantly different in groups A and B. The total lymphocyte-count (mean 2117 +/- S.E.M. 375 cells/mm3) in a further nineteen patients with measles who had died, studied retrospectively, was significantly lower than that (4487 +/- 540 cells/mm3) in twenty-seven patients with measles who recovered.

摘要

在随后死亡的5名麻疹患儿以及1名患麻疹并发展为慢性支气管肺炎的患儿(A组)中,急性皮疹期(即死亡前3 - 20天)的免疫抑制比6名康复的麻疹患儿(B组)更为明显。A组的绝对总淋巴细胞计数(T细胞和B细胞)显著更低。A组的平均血清C3也低于B组。两组在其他补体因子或血清免疫球蛋白方面无显著差异。A组患者淋巴细胞的平均植物血凝素刺激指数(S.I.)与B组相似,尽管两组的S.I.均显著低于健康对照组。两名死亡患者的S.I.S最低。A组和B组的白细胞总数、中性粒细胞、裸细胞以及同时具有B细胞和T细胞标志物的细胞计数无显著差异。对另外19名已死亡的麻疹患儿进行回顾性研究发现,其总淋巴细胞计数(平均2117±标准误375个细胞/mm³)显著低于27名康复的麻疹患儿(4487±540个细胞/mm³)。

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