【摘要】 目的探讨气阴两虚反复下呼吸道感染 (RLRTI)患儿T细胞功能障碍情况及增免合剂的免疫调节作用 ,为有效治疗该病寻找理论依据。方法采用免疫荧光标记和流式细胞仪技术 ,检测了 31例轻型和 2 8例重型RLRTI患儿治疗前感染期及增免合剂治疗后 3个月和 6个月非感染期外周血T细胞亚群和与T细胞活化有关的CD3+/HLA DR+和CD3+/CD2 5+等表面分子的表达情况。结果轻型RLRTI治疗前CD4 +细胞和CD3+/HLA DR+活化T细胞的表达率均明显降低 ,治疗后 3个月CD4 +、CD3+/HLA DR- 静止T细胞、CD3+/HLA DR+活化T细胞及CD3+/CD2 5+表达IL 2R的T细胞的阳性率均明显降低 ;但治疗 6个月后 ,只有CD3+/HLA DR+活化T细胞的表达率低于对照组。重型RLRTI患儿治疗前 ,CD3+、CD4 +、CD3+/HLA DR- 、CD3+/HLA DR+和CD3+/CD2 5+的表达率均降低 ,治疗 3个月和 6个月后上述指标似有恢复 ,但仍低于对照组。增免合剂的临床效果显示 ,轻型总有效率是 10 0 % ,其中显效 78 9% ;重型总有效率是 90 9% ,显效 6 8 2 %。结论气阴两虚RLRTI患儿T细胞数减少 ,T细胞活化功能障碍 ,病情轻、重与T细胞功能障碍情况一致。增免合剂治疗RLRTI临床疗效显著 ,对T细胞功能障碍有明显的调节作用 ,但实验指标的恢复可能需要治疗更长的时间更多还原

【Abstract】 ObjectiveTo explore the T-lymphocyte dysfunction in children with repeated infection of lower respiratory tract of both Qi Yin deficiency type (RIR QYD) and the immune regulatory effect of Zengmian mixture (ZMM), to provide theoretical basis for the effective therapy. MethodsPeripheral T lymphocyte subsets and expressions of T lymphocyte activating related surface molecules (CD 3 +/HLA DR + and CD 3 +/CD 25 +, etc.) in children with RIR QYD, 31 of mild type and 28 of severe type cases, were investigated before administration of ZMM and after treatment of ZMM for 3 6 months (non infectious stage), using immune fluorescent labelling and flow cytometric technique. ResultsIn the patients with mild RIR QYD, the expression rate of CD 4 + and CD 3 +/HLA DR + activated T cells before treatment were all obviously lowered, after 3 months treatment, the positive rate of CD 4 +, CD 3 +/HLA DR - resting T cell, CD 3 +/HLA DR + activated T cell and CD 3 +/CD 25 + express IL 2R T cells were all obviously lowered, but after treatment for 6 months, only that of CD 3 +/HLA DR + activated T cells was lower than that in the control group. In the patients with severe RRI QYD before treatment, the expression rate of CD 3 +, CD 4 +, CD 3 +/HLA DR -, CD 3 +/HLA DR + and CD 3 +/CD 25 + all lowered, while after 3-6 months treatment, some recoveries were shown in these parameters but still lower than those in the control group. The total effective rate of ZMM for mild patients was 100%, and the markedly effective rate 78.9%, while for severe cases, the total effective rate was 90 9% and the markedly effective rate 68 2%. ConclusionIn patients with RIR QYD, the T cells decreased with activating dysfunction, the severity of disease is in accordance with the degree of T cell activating dysfunction. ZMM shows markedly clinical effect in treating RIR QYD and evident regulatory effect on T cell dysfunction, but a long term treatment is needed for the recovery of laboratory parameters.更多还原