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目的观察重症病毒性脑炎患儿T淋巴细胞亚群变化,探讨其临床意义。方法选取2009年6月—2012年6月山东大学齐鲁儿童医院收治的病毒性脑炎患儿60例,其中轻、重型患儿各30例,分别作为轻型组、重型组。同时选取健康儿童30例作为对照组。轻型组患儿给予常规治疗,重型组患儿在常规治疗基础上给予大剂量甲泼尼龙联合丙种球蛋白治疗。比较3组受试者T淋巴细胞亚群及重型组不同预后患儿治疗前后T淋巴细胞亚群。结果轻型组患儿CD+3、CD+4、CD+8细胞分数及CD+4/CD+8细胞比值与对照组比较,差异均无统计学意义(P>0.05);重型组患儿CD+3、CD+4细胞分数均低于对照组、轻型组,CD+8细胞分数、CD+4/CD+8细胞比值均高于对照组、轻型组(P<0.05)。重型组预后良好患儿治疗后CD+3、CD+4细胞分数及CD+4/CD+8细胞比值均高于治疗前,CD+8细胞分数低于治疗前(P<0.05);重型组预后不良患儿治疗后CD+3、CD+4细胞分数及CD+4/CD+8细胞比值高于治疗前(P<0.05),而治疗前后CD+8细胞分数比较,差异无统计学意义(P>0.05)。结论重症病毒性脑炎患儿常伴有T淋巴细胞亚群改变,检测重症病毒性脑炎患儿T淋巴细胞亚群有助于判断病情严重程度及预后效果。
Objective To observe the changes of T lymphocyte subsets in children with severe viral encephalitis and to explore its clinical significance. Methods Sixty children with viral encephalitis who were admitted to Qilu Children’s Hospital of Shandong University from June 2009 to June 2012 were selected, of which 30 were light and heavy children, respectively, as light and heavy groups. At the same time, 30 healthy children were selected as the control group. Patients in the light group were treated routinely. Patients in the heavy group received high-dose methylprednisolone plus gamma globulin after conventional treatment. The T lymphocyte subsets of T lymphocyte subsets and severe group of children with different prognosis before and after treatment were compared. Results There was no significant difference in the scores of CD + 3, CD 4 +, CD 8 + and CD 4 + CD 8 between the control group and the light group (P> 0.05) +3, CD +4 cells were lower than those in the control group. The scores of light and CD + 8 cells and CD + 4 / CD + 8 cells in control group and light group were significantly higher than those in control group (P <0.05). The percentage of CD + 3, CD + 4 cells and CD + 4 / CD + 8 cells in children with good prognosis were significantly higher than those before treatment (P <0.05) The prognosis of children with poor prognosis after treatment CD +3, CD +4 cells and CD +4 / CD +8 cells ratio was higher than before treatment (P <0.05), while before and after treatment CD + 8 cell fraction, the difference was not statistically significant (P> 0.05). Conclusions Children with severe viral encephalitis often have changes of T lymphocyte subsets. Detection of T lymphocyte subsets in children with severe viral encephalitis can help to determine the severity and prognosis of children with severe viral encephalitis.