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目的研究儿童幽门螺杆菌(H.pylori)感染时的T淋巴细胞亚群变化。方法流式细胞仪直接免疫荧光法测定38例[H.pylori+慢性浅表性胃炎(CSG)12例;H.pylori+十二指肠溃疡(DU)5例;H.pylori-CSG21例]儿童胃窦黏膜及外周血T淋巴细胞亚群。各组患儿均在内镜检查下取胃窦黏膜作快速尿素酶试验、组织学检查及淋巴细胞提取,同时抽取外周肝素抗凝静脉血2mL。提取的淋巴细胞经CD3FITC、CD4PE、CD8PerCP染色后行流式测定。其中,胃黏膜T淋巴细胞亚群的检测以CD3设门。结果(1)胃黏膜CD+3(%)细胞的检出率分别为:H.pylori-CSG组3.14±2.03,H.pylori+CSG组4.58±2.30,H.pylori+DU组为6.49±4.49;(2)胃黏膜CD+3细胞中CD+4(%),CD+8(%)的相对比例及CD+4/CD+8值分别为:H.pylori-CSG组为19.81±9.25,47.30±12.83,0.43±0.19,H.pylori+CSG组为40.66±12.52,29.25±8.58,1.42±0.31,H.pylori+DU组为31.98±14.02,49.52±19.00,0.72±0.43。H.pylori+CSG组局部胃窦黏膜CD+4细胞、CD+4/CD+8比值明显高于H.pylori-CSG组,CD+8细胞则低于H.pylori-CSG组(P<0.01)。H.pylori+DU组CD+4、CD+4/CD+8比值也高于H.pylori-CSG组(P<0.05),但CD+8细胞无统计学差异。H.pylori+DU组CD+8细胞高于H.pylori+CSG组而CD+4细胞无统计学差异,CD+4/CD+8比值则低于H.pylori+CSG组(P<0.01)。(3)外周血T淋巴细胞亚群的变化在三组之间并无明显的差异。结论H.pylori+DU与H.pylori+CSG的宿主的T淋巴细胞反应并不相同,而局部胃窦黏膜的T淋巴细胞亚群的异常可能在儿童H.pylori感染的免疫致病机制中起一定的作用。
Objective To study the changes of T lymphocyte subsets in children with H.pylori infection. Methods Thirty-eight cases of H.pylori + chronic superficial gastritis (CSG), 12 cases of H.pylori + duodenal ulcer (DU) and 21 cases of H.pylori-CSG were studied by flow cytometry. Sinus mucosa and peripheral blood T lymphocyte subsets. Each group of children under the endoscopy take antral mucosa for rapid urease test, histological examination and lymphocyte extraction, while taking peripheral blood anticoagulation venous blood 2mL. Lymphocytes extracted by CD3FITC, CD4PE, CD8PerCP staining after flow cytometry. Among them, gastric mucosal T lymphocyte subsets were detected by CD3. Results The detection rates of CD + 3 (%) cells in gastric mucosa were 3.14 ± 2.03 in H.pylori-CSG group, 4.58 ± 2.30 in H.pylori + CSG group and 6.49 ± 4.49 in H.pylori + DU group ; (2) The relative proportions of CD + 4 (%), CD + 8 (%) and CD + 4 / CD + 8 in gastric mucosal CD + 3 cells were respectively 19.81 ± 9.25 in H.pylori-CSG group, 47.30 ± 12.83, 0.43 ± 0.19, respectively. The H.pylori + CSG group was 40.66 ± 12.52,29.25 ± 8.58,1.42 ± 0.31, and the group of H.pylori + DU was 31.98 ± 14.02,49.52 ± 19.00,0.72 ± 0.43. The ratio of CD + 4 / CD + 8 in gastric mucosa of H.pylori + CSG group was significantly higher than that in H.pylori-CSG group and CD + 8 cells in H.pylori-CSG group (P <0.01) ). The ratio of CD + 4 and CD + 4 / CD + 8 in H.pylori + DU group was also higher than that in H.pylori-CSG group (P <0.05), but there was no significant difference in CD + 8 cells. The CD + 8 cells in H.pylori + DU group were significantly higher than those in H.pylori + CSG group, while the CD + 4 / CD + 8 ratio was lower in H.pylori + CSG group than in H.pylori + CSG group (P <0.01) . (3) There was no significant difference between the three groups in the changes of T lymphocyte subsets in peripheral blood. Conclusions The T lymphocyte response of H.pylori + DU to H.pylori + CSG is not the same, but abnormality of T lymphocyte subsets in local antral mucosa may play an important role in the pathogenesis of H.pylori infection A certain role.