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目的:检测传染性单核细胞增多症(Infectious Mononucleosis,IM)患儿外周血淋巴细胞CD3+、CD4+、CD8+、活化T淋巴细胞表面标记CD3+HLA-DR+、CD3+CD25+、CD8+HLA-DR+、CD8+CD38+和调节性T细胞CD4+CD25+比例,研究其变化规律,探讨疾病发生机制和病程变化指标。方法:收集IM患儿急性期、恢复期和正常儿童对照全血标本,采用流式细胞仪检测淋巴细胞表面标记CD3+、CD4+、CD8+、CD3+HLA-DR+、CD3+CD25+、CD8+HLA-DR+、CD8+CD38+和调节性T细胞CD4+CD25+表达比例。结果:与正常对照组比较,IM患儿急性期CD3+、CD8+、CD3+HLA-DR+、CD8+HLA-DR+、CD8+CD38+比例显著升高;而CD4+、CD4+/CD8+比值和调节性T细胞CD4+CD25+比例则明显下降;CD3+CD25+无明显变化;恢复期患儿淋巴细胞表面CD3+、CD8+、CD3+HLA-DR+、CD8+HLA-DR+、CD8+CD38+逐渐降低,CD4+CD25+表达逐渐升高。结论:IM患儿处于免疫活化和失衡状态,T淋巴细胞显著增殖,CD8+T细胞明显活化。多种反应T细胞活化的指标CD3+HLA-DR+、CD8+HLA-DR+、CD8+CD38+和调节性T细胞CD4+CD25+比例可以很好地评价IM患儿病情和机体免疫状态。
Objective: To detect the expression of CD3 +, HLA-DR, CD3 + CD25 +, CD8 + HLA-DR + on peripheral blood lymphocytes in children with infectious mononucleosis (IM) CD8 + CD38 + regulatory T cells CD4 + CD25 + ratio, to study the variation of the disease mechanism and duration of disease indicators. Methods: Whole blood samples from acute, convalescent and normal children with IM were collected. The expression of CD3 +, CD4 +, CD8 +, CD3 + HLA-DR +, CD3 + CD25 +, CD8 + HLA- DR + , CD8 + CD38 + and regulatory T cells CD4 + CD25 + expression ratio. Results: Compared with the normal control group, the proportion of CD3 +, CD8 +, CD3 + HLA-DR +, CD8 + HLA-DR + and CD8 + CD38 + in acute stage of IM patients was significantly increased; CD4 +, CD4 + / CD8 + CD25 +, CD38 +, HLA-DR +, CD8 +, CD38 + of CD3 +, CD8 +, HLA-DR +, CD8 + CD38 + lymphocytes in convalescent children decreased gradually and CD4 + CD25 + . CONCLUSIONS: IM patients are immunologically activated and imbalanced with T lymphocyte proliferation and CD8 + T cell activation. A variety of reactive T-cell activation indicators CD3 + HLA-DR +, CD8 + HLA-DR +, CD8 + CD38 + and regulatory T cells CD4 + CD25 + ratio can be a good evaluation of children with IM disease and immune status.