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目的探讨T淋巴细胞亚群及体液免疫在儿童病毒性脑炎发病过程中的变化规律及其临床意义。方法选取病毒性脑炎患儿67例,分别于发病急性期及治疗后稳定期抽取患儿空腹静脉血,分离血清;采用流式细胞仪测定T淋巴细胞亚群T、Th、Ts、Th/Ts、NK及CIK水平,采用ELISA试剂盒测定免疫球蛋白IgG、IgA、IgM及补体C3、C4水平;并与同期入院体检的41例健康志愿儿童做对比性分析。结果 T淋巴细胞亚群:患儿发病急性期T、Th、Th/Ts、NK及CIK水平均显著低于稳定期(P<0.05),且稳定期各指标均显著低于对照组(P<0.05);Ts水平在各组之间无显著差异(P>0.05)。体液免疫:患儿发病急性期免疫球蛋白IgA、IgM水平及补体C3、C4显著低于稳定期(P<0.05或P<0.01),且稳定期各指标均显著高于对照组(P<0.05或P<0.01);IgG水平在各组之间无显著差异(P>0.05)。结论病毒性脑炎起病及进展过程中,患儿外周血T淋巴细胞亚群、免疫球蛋白及补体水平呈普遍下降趋势;机体细胞免疫和体液免疫功能薄弱,病毒通过血脑屏障进入中枢神经系统,可能为儿童病毒性脑炎的重要致病因素之一。
Objective To investigate the changes and clinical significance of T lymphocyte subsets and humoral immunity in the pathogenesis of viral encephalitis in children. Methods Sixty-seven children with viral encephalitis were selected and their fasting venous blood samples were collected at the acute stage and post-treatment stable stage respectively. The levels of T, Th, Ts and Th / Ts, NK and CIK levels were determined by enzyme-linked immunosorbent assay (ELISA), and the levels of IgG, IgA, IgM and C3 and C4 were measured. The results were compared with 41 healthy volunteers who were admitted to hospital during the same period. Results T lymphocyte subsets: The levels of T, Th, Th / Ts, NK and CIK in acute stage were significantly lower than those in stable stage (P <0.05), and the indexes in stable stage were significantly lower than those in control group (P < 0.05). There was no significant difference in Ts between the groups (P> 0.05). Humoral immunity: Immunoglobulin IgA, IgM levels and complement C3, C4 in children with acute onset were significantly lower than those in stable phase (P <0.05 or P <0.01), and the indexes in stable phase were significantly higher than those in control group (P <0.05 Or P <0.01). There was no significant difference in IgG levels between groups (P> 0.05). Conclusion The onset and progression of viral encephalitis in children with peripheral blood T lymphocyte subsets, immunoglobulin and complement levels showed a general downward trend; the body’s cellular immunity and humoral immunity is weak, the virus through the blood-brain barrier into the central nervous system System, may be one of the important causative agents of viral encephalitis in children.