Seth V, Kabra S K, Beotra A, Semwal O P
Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi.
Indian Pediatr. 1993 Oct;30(10):1181-6.
Thirty children in the age group 0-4 years with tuberculous meningitis (TBM) were investigated for their immune status (cell-mediated and humoral). Twenty age, sex and nutritional status matched children were investigated on the same lines, who served as controls. Absolute T cell counts were significantly increased (3126 +/- 1623) (p < 0.01) in TBM, though T cell percentages were comparable (59.8% in TBM versus 54.44% in controls). Leucocyte migration inhibition (LMI) test positivity was high (93%) in TBM patients. Mean LMI index showed a highly statistically significant difference (p < 0.001) between the 'Before-therapy' (0.62 +/- 0.16) and 'During-therapy' (0.77 +/- 0.23) groups in TBM patients. Mantoux test positivity with 1 TU of PPD was low (53.0%) in TBM in comparison to LMIT positivity. In humoral immune response, quantitative function measured by EAC rosettes was not altered. However, there was a significant decrease in the levels of IgA (79.48 +/- 33.78 IU) (p < 0.01), IgG (115.01 +/- 32.56 IU) (p < 0.01) and IgM (148.50 +/- 51.88 IU) (p < 0.05) in TBM patients. There was no significant difference in the complement levels in the TBM and control groups. The results show a well developed CMI response but a poor humoral response in TBM and represent an inverse relationship between the CMI and humoral responses.
对30名0至4岁患有结核性脑膜炎（TBM）的儿童进行了免疫状态（细胞介导免疫和体液免疫）调查。按照相同方法对20名年龄、性别和营养状况相匹配的儿童进行了调查，这些儿童作为对照。TBM患儿的绝对T细胞计数显著增加（3126±1623）（p<0.01），尽管T细胞百分比相当（TBM组为59.8%，对照组为54.44%）。TBM患者的白细胞迁移抑制（LMI）试验阳性率较高（93%）。TBM患者“治疗前”组（0.62±0.16）和“治疗期间”组（0.77±0.23）的平均LMI指数显示出高度统计学差异（p<0.001）。与LMI试验阳性率相比，TBM患者结核菌素纯蛋白衍生物（PPD）1结核菌素单位皮试阳性率较低（53.0%）。在体液免疫反应中，通过EAC玫瑰花结测量的定量功能未改变。然而，TBM患者的IgA水平（79.48±33.78 IU）（p<0.01）、IgG水平（115.01±32.56 IU）（p<0.01）和IgM水平（148.50±51.88 IU）（p<0.05）显著降低。TBM组和对照组的补体水平无显著差异。结果显示，TBM患者的细胞介导免疫反应良好，但体液免疫反应较差，且细胞介导免疫和体液免疫反应之间呈负相关。
