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目的了解病毒性肺炎患儿外周血自然杀伤细胞(NK细胞)和淋巴细胞亚群的改变。方法选取57例住院的病毒性肺炎患儿作为病毒性肺炎组。患儿入院时肺部听诊均可闻及中小湿啰音;末梢血白细胞总数正常或低于正常,肺部X线片有点片状阴影。采用鼻咽部分泌物间接免疫荧光和(或)病毒血清IgM抗体检测方法进行病毒性肺炎病原学检测。病毒性肺炎的病原学检测结果:呼吸道合胞病毒34例,流感病毒9例,副流感病毒10例,腺病毒3例,柯萨奇病毒1例。57例患儿均无其他病原感染的临床及实验室证据。健康对照组为门诊体检健康儿童34例。采用流式细胞仪对57例病毒性肺炎患儿及健康对照组儿童外周静脉血行NK细胞和淋巴细胞亚群检测,应用SPSS 10.0软件分析。结果病毒性肺炎组NK细胞平均百分率较健康对照组明显降低[(13.38±5.98)%vs(18.26±9.52)%,P=0.010],B细胞百分率与健康对照组比较差异无统计学意义[(27.52±21.32)%vs(20.41±7.19)%,P=0.087],而CD4+细胞平均百分率及CD4+/CD8+比值均较健康对照组明显升高[(39.98±9.12)%vs(34.23±8.41)%,P=0.005;(1.83±0.60)vs(1.67±1.00),P=0.018]。结论儿童患病毒性肺炎时,作为抗感染第一道天然防线的NK细胞未能阻碍病情的发展,特异性细胞免疫可能发挥更重要的作用。
Objective To understand the changes of natural killer (NK) cells and lymphocyte subsets in children with viral pneumonia. Methods 57 children with viral pneumonia were selected as viral pneumonia group. Pulmonary auscultation on admission to children can be heard in small and medium wet rales; the total number of peripheral blood leukocytes normal or below normal, a little piece of lung shadow X-ray film. Pathogenicity of viral pneumonia was detected by indirect immunofluorescence and / or viral serum IgM antibody detection of nasopharyngeal secretions. Etiological test results of viral pneumonia: respiratory syncytial virus in 34 cases, 9 cases of influenza virus, parainfluenza virus in 10 cases, adenovirus in 3 cases, Coxsackie virus in 1 case. 57 cases of children with no other pathogenic clinical and laboratory evidence. Healthy control group was outpatient physical examination of 34 healthy children. Flow Cytometry in children with viral pneumonia in 57 children and healthy children peripheral blood samples of NK cells and lymphocyte subsets detected by SPSS 10.0 software analysis. Results The average percentage of NK cells in viral pneumonia group was significantly lower than that in healthy controls [(13.38 ± 5.98)% vs (18.26 ± 9.52)%, P = 0.010]. There was no significant difference in the percentage of B cells among healthy controls The mean percentage of CD4 + cells and the ratio of CD4 + / CD8 + were significantly higher than those in healthy controls [(39.98 ± 9.12)% vs (34.23 ± 8.41)%, P <0.001] , P = 0.005; (1.83 ± 0.60) vs (1.67 ± 1.00), P = 0.018]. Conclusion In children with viral pneumonia, NK cells, as the first natural anti-infective line, failed to hinder the progression of the disease and specific cellular immunity may play a more important role.