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目的探讨呼吸道合胞病毒(RSV)支气管肺炎患儿外周血单个核细胞(PBMCS)高迁移率族蛋白B-1(HMGB1)mRNA表达,及血浆肿瘤坏死因子-α(TNF-α)水平、T细胞亚群,并探讨HMGB1、TNF-α、T细胞亚群在RSV支气管肺炎免疫发病机制中的临床意义。方法对2007年9月至2009年3月于苏州大学附属儿童医院呼吸科住院治疗的52例RSV支气管肺炎患儿,其中25例为呼吸道合胞病毒(RSV)感染,27例为RSV和细菌混合感染。同时选择23例健康儿童作对照组,应用逆转录聚合酶链反应(RT-PCR)方法对其PBMCS HMGB1mRNA表达进行检测,并应用ELLSA法检测外周血浆TNF-α,流式细胞仪检测T细胞亚群。结果 (1)3组间PBMCS HMGB1mRNA的表达、血浆TNF-α水平差异有统计学意义(P<0.05),RSV感染组和混合感染组HMGB1的表达差异有统计学意义(P<0.05);(2)CD3+、CD3+CD8+、CD3-CD19+、CD19+CD23+、CD3-CD(16+56)+的百分比在3组间差异均有统计学意义(P<0.05);(3)CD3+、CD3+CD8+、CD3-CD(16+56)+亚群:RSV感染组和混合感染组之间差异无统计学意义(P>0.05),但较对照组有明显降低(P<0.05);(4)CD3-CD19+RSV感染组和混合感染组之间差异无统计学意义,但较对照组明显增高(P<0.05);(5)CD3+CD4+、CD4+CD25+在3组间差异无统计学意义(P>0.05);(6)混合感染组CD19+CD23+、CD4+CD25+较对照组明显增高,差异有统计学意义(P<0.05)。结论 HMGB1可能参与了RSV和细菌混合感染支气管肺炎的免疫发病过程,HMGB1与TNF-α作用机制可能不同。
Objective To investigate the expression of high mobility group box-1 (HMGB1) mRNA and the level of tumor necrosis factor-α (TNF-α) in peripheral blood mononuclear cells (PBMCS) of children with respiratory syncytial virus (RSV) And to explore the clinical significance of HMGB1, TNF-α and T cell subsets in the pathogenesis of RSV bronchopneumonia. Methods From September 2007 to March 2009, 52 children with RSV bronchial pneumonia who were hospitalized in Respiratory Department of Children’s Hospital Affiliated to Soochow University were enrolled. Among them, 25 were respiratory syncytial virus (RSV) infection and 27 were RSV mixed with bacteria infection. At the same time, 23 healthy children were selected as control group. The expression of HMGB1 mRNA in PBMCs was detected by reverse transcription-polymerase chain reaction (RT-PCR). TNF-α in peripheral blood was detected by ELLSA and flow cytometry group. Results (1) The expression of HMGB1 mRNA and the level of plasma TNF-α in PBMCS were significantly different among the three groups (P <0.05). There were significant differences in HMGB1 expression between RSV group and mixed group (P <0.05) 2) The percentage of CD3 +, CD3 + CD8 +, CD3-CD19 +, CD19 + CD23 + and CD3- CD (16 + 56) + were all significantly different among the three groups (P < CD8 +, CD3-CD (16 + 56) + subgroup: There was no significant difference between RSV infection group and mixed infection group (P> 0.05), but significantly lower than that of control group (P <0.05) There was no significant difference between CD3-CD19 + RSV infection group and mixed infection group, but it was significantly higher than that of control group (P <0.05). (5) There was no significant difference in CD3 + CD4 +, CD4 + CD25 + (P> 0.05). (6) The levels of CD19 + CD23 +, CD4 + CD25 + in mixed infection group were significantly higher than those in control group (P <0.05). Conclusion HMGB1 may be involved in the pathogenesis of bronchopneumonia induced by RSV and bacterial mixed infection. The mechanism of HMGB1 and TNF-α may be different.