【摘要】 目的探讨急性腹泻患儿外周血T淋巴细胞亚群分布及相关细胞因子的变化及意义。方法选取华中科技大学同济医学院附属同济医院急诊科收治的60例急性腹泻患儿作为研究组,健康体检儿童60例作为对照组。比较两组肠道菌群变化,以及C反应蛋白(CRP)、二胺氧化酶(DOA)、D-乳酸(D-Lac)水平。采用流式细胞仪检测外周血T细胞亚群(CD3~+、CD4~+、CD8~+、CD4~+/CD8~+),酶联免疫吸附法检测细胞因子[白介素-2(IL-2)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)]变化及意义。结果研究组双歧杆菌、乳酸菌和B/E值均显著低于对照组(P<0.05),肠杆菌高于对照组(P<0.05),两组肠球菌比较差异无统计学意义(P>0.05);研究组CRP、DOA、D-Lac水平明显高于对照组(P<0.05);研究组CD3+、CD4+、CD4+/CD8~+水平均低于对照组(P<0.05),CD8~+水平高于对照组(P<0.05);研究组IL-2、IL-6、TNF-α、IFN-γ水平显著高于对照组,两组比较差异有统计学意义(P<0.05)。结论急性腹泻患儿存在菌群失调和肠黏膜损伤现象,外周血T淋巴细胞亚群和相关细胞因子IL-2、IL-6、TNF-α、IFN-γ参与急性腹泻患儿的免疫机制及炎症反应,对急性腹泻的发生发展及预后有重要意义。更多还原

【Abstract】 Objective To investigate the distribution of T lymphocyte subsets in peripheral blood of children with acute diarrhea and the change and significance of related cell factor. Methods 60 cases of children with acute diarrhoea in the emergency department of our hospital were selected as the study group,and 60 healthy children were selected as the control group. The changes of intestinal flora in the two groups were compared,as well as C-reactive protein( CRP),diamine oxidase( DOA),and D-lactic acid( D-Lac). T cell subsets( CD3+,CD4+,CD8+,CD4+/CD8+) of peripheral blood were detected by flow cytometry,enzyme linked immunosorbent assay( ELISA) was used to detect the changes and significance of cytokines [interleukin-2( IL-2),interleukin-6( IL-6),tumor necrosis factor-α( TNF-α) and interferon-γ( IFN-γ) ]. Results The bifidobacteria,lactic acid bacteria and B/E value in the study group were significantly lower than those in the control group( P < 0. 05),the enterobacteria was higher than that in the control group( P < 0. 05),there was no significant difference in enterococcus between the two groups( P > 0. 05). The levels of CRP,DOA and D-Lac in the study group were significantly higher than those in the control group( P < 0. 05). The levels of CD3~+,CD4~+ and CD4~+/CD8~+ in the study group were significantly lower than those in the control group( P < 0. 05). The level of CD8~+ was higher than that in the control group( P < 0. 05). The levels of IL-2,IL-6,TNF-α,and IFN-γ in the study group were significantly higher than those in the control group,and the difference between the two groups was statistically significant( P< 0. 05). Conclusion Children with acute diarrhoea have flora imbalance and intestinal mucosal injury,the peripheral blood T lymphocyte subset and related cell factors,like IL-2,IL-6,TNF-α,and IFN-γ are involved in the immune mechanism and inflammatory response in children with acute diarrhea,it is of great significance for the development and prognosis of acute diarrhea.更多还原