【摘要】 目的检测甲型H1N1流感患儿Th细胞亚群的动态变化,探讨甲型H1N1流感的发病机制,并评价患儿的免疫状况及与疾病严重程度和预后的关系。方法总结19例甲型H1N1流感患儿Th细胞亚群动态变化,选择21例健康儿童作为健康对照组。采用流式细胞仪计数INF-γ+细胞占CD3+CD8-T细胞百分比(Th1%)和IL-4+占CD3+CD8-T细胞百分比(Th2%),并计算Th1与Th2的比值。结果 19例甲型H1N1流感患儿中,存活15例(78.9%),死亡4例(21.1%)。健康对照组、存活组和死亡组三组儿童性别、年龄无显著性差异;入院时,甲型H1N1流感患儿存活组和死亡组Th1%、Th2%和Th1/Th2分别为6.65%(0.62%～25.30%)vs.7.26%(4.66%～14.03%)、1.40%(0.31%～5.41%)vs.1.69%(1.52%～2.42%)、6.15%(2.0%～14.46%)和3.84%(3.03%～7.67%),Th1%较健康对照组无明显改变,Th2%显著升高、Th1/Th2显著下降(P均<0.01);存活的甲型H1N1流感患儿Th1%逐渐升高,Th1/Th2比例有可逆性下降,最终升高;而同期死亡者Th1/Th2比例不可逆性下降,直至死亡,较存活组和健康组有显著性差异(P<0.05)。结论甲型H1N1流感急性期为Th2细胞占优势型,存在免疫抑制;Th1/Th2的平衡可以影响机体的免疫状态,动态监测还可对疾病的程度和预后做出判断。更多还原

【Abstract】 Objective To monitor the dynamic changes of Th cell in influenza A (H1N1) virus infection children and study the pathogenesis of the disease and evaluate their immunological condition,relationship between severity of illness and prognosis.Methods Th1%,Th2% and Th1/Th2 in peripheral blood were detected dynamically by Flow Cytometry in 19 children with H1N1 infection who were hospitalized in affiliated hospital of capital institute of pediatrics.Twenty-one healthy children were selected as healthy control group.Results Among 19 H1N1 infection patients,15 alive (78.9%),4 died (21.1%).There was no significant difference in sex and age in these three groups.Compared with control group,the Th1%,Th2% and Th1/Th2 of children in H1N1 infection alive and died groups were 6.65% (0.62% ～25.30%)、 7.26%(4.66%～14.03%)、1.40%(0.31%～5.41%) and 1.69%(1.52%～2.42%)、6.15%(2.0～14.46) and 3.84%(3.03% ～7.67%),respectively.The Th1% had no significant changes,whereas Th2% and Th1/Th2 were significantly increased and decreased (P < 0.01).The Th1/Th2 decreased reversibly in the cured H1N1 patients,but decreased progressively in the dead cases (P < 0.05).Conclusions There is an increase in Th2 response that may lead to immune suppression in children with influenza A (H1N1) virus infection.Th1/Th2 imbalance could affect the immune status and dynamic detective may make a decision for the severity degree and prognosis of the disease.更多还原