| 刘颖业,田洋洋,李军,等.外周血淋巴细胞亚群测定在儿童传染性单核细胞增多症早期诊断中的临床意义[J].安徽医药,2025,29(12):2375-2379. |
| 外周血淋巴细胞亚群测定在儿童传染性单核细胞增多症早期诊断中的临床意义 |
| Clinical significance of peripheral blood lymphocyte subsets detection in early diagnosis of infectious mononucleosis in children |
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| DOI：10.3969/j.issn.1009-6469.2025.12.009 |
| 中文关键词: 传染性单核细胞增多症 淋巴细胞亚群 肝功能 流式细胞术 儿童 |
| 英文关键词: Infectious mononucleosis Lymphocyte subsets Liver function Flow cytometry Child |
| 基金项目:河北省医学科学研究课题计划资助项目(20200676) |
| 作者 | 单位 | E-mail | | 刘颖业 | 河北医科大学附属河北省儿童医院,儿童健康与疾病临床医学研究中心,河北石家庄 050031
河北医科大学附属河北省儿童医院,儿科研究所,河北石家庄 050031 | | | 田洋洋 | 河北医科大学基础医学院组织学与胚胎学教研室,河北石家庄 050017 | | | 李军 | 河北医科大学附属河北省儿童医院,儿童健康与疾病临床医学研究中心,河北石家庄 050031
河北医科大学附属河北省儿童医院,质量控制处,河北石家庄 050031 | | | 郭巍巍 | 河北医科大学附属河北省儿童医院,儿童健康与疾病临床医学研究中心,河北石家庄 050031
河北医科大学附属河北省儿童医院,儿科研究所,河北石家庄 050031 | 13831169605@163.com |
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| 中文摘要: |
| 目的探讨淋巴细胞亚群在儿童传染性单核细胞增多症( IM)中的特点，为早期诊断提供理论参考依据。方法回顾性分析 2022年 1月至 2023年 12月河北医科大学附属河北省儿童医院收治的 IM病儿 62例，依据是否出现肝功能异常，分为肝功能正常组( n=31)和肝功能异常组( n=31)。同时选取非病毒感染的儿童 31例作为对照组。采用流式细胞术检测病儿外周血淋巴细胞亚群的百分比和表达数量，分析淋巴细胞亚群指标［T淋巴细胞(CD3+)、辅助性 T淋巴细胞( CD3+CD4+)、细胞毒性 T淋巴细(CD3+CD8+)CD3+CD4+/CD3+CD8+B淋巴细胞(CD19+)自然杀伤淋巴细胞(CD16+CD56+)］的水平变化及意义。采用 Spearman相胞关分析IM病儿、血清丙氨酸氨基转移、酶( ALT)水平与各、项检测指标水平的相关性。结果 IM组病儿 CD3+细胞的百分比、 CD3+CD8+细胞的百分比和显著高于对照组(P<0.05)而 CD3+CD4+细胞的百分比、 CD19+细胞百分比、 CD16+CD56+细胞百分比和 CD3+CD4+/CD3+CD8+显著低于对照组(P<0.05)。肝功能，异常组病儿 CD3+细胞的百分比 86.72%(81.36%，89.98%)，显著高于肝功能正常组的 84.29%(78.58%，87.04%)而 CD19+的百分比为 3.62%(2.89%，6.62%)显著低于肝功能正常组的 5.33%(4.45%，9.17%)。肝功能异常组病儿 CD3+绝对值和 CD3+CD8+14(5 077，11 164)个 /微升、 4 614(3 220，8 103)个/微升，显著高于肝功能正常组［4 798(3 166，7 140)个/微升、 2 962(2 401，4 918)个/微升］(P<0.05)。Spearman相关分析结果显示， IM病儿 ALT水平与 CD3+细胞的绝对值计数和 CD3+CD8+T细胞的绝对值计数呈正相关(rs=0.34、0.31，P=0.007、0.015)。细胞的，细胞的绝对值分别为60，结论 外周血淋巴细胞亚群测定在儿童 IM合并肝功能异常的病情评估中发挥着重要作用，监测淋巴细胞亚群指标的百分比和计数的变化，能为临床早期诊断 IM提供有力的科学依据，有助于减少并发症的发生风险，进一步改善病儿的预后情况。 |
| 英文摘要: |
| Objective To explore the characteristics of lymphocyte subsets in infectious mononucleosis (IM) in children and to pro-vide a theoretical reference for early diagnosis.Methods This study retrospectively analyzed the data on 62 children with IM admittedto Hebei Children's Hospital Affiliated to Hebei Medical University from January 2022 to December 2023. Based on the presence orabsence of liver dysfunction,, they were assigned to normal liver function group (n=31) or liver dysfunction group (n=31). Meanwhile, 31 children with non-viral infection were selected as the control group. Flow cytometry was used to detect the percentage and expression ofperipheral blood lymphocyte subsets in children, and the expression changes and significance of lymphocyte subset indicators (CD3+,CD3+CD4+, CD3+CD8+, CD3+CD4+/CD3+CD8+, CD19+, CD16+CD56+) were analyzed. Spearman correlation was used to analyze the corre-lation between serum alanine aminotransferase (ALT) level and various detection indexes in children with IM.Results The percentage of CD3+ cells and the percentage of CD3+CD8+ cells in children in the IM group were significantly higher than those in the control group, while the percentages of CD3+CD4+ cells, CD19+ cells, CD16+CD56+ cells and the CD3+CD4+/CD3+CD8+ ratio were significantly lower (P<0.05). In the liver dysfunction group, the percentage of CD3+ cells was 86.72% (81.36%, 89.98%), which was significantly higher than 84.29% (78.58%,87.04%) in the normal liver function group, while the percentage of CD19+ was 3.62% (2.89%, 6.62%),which was significantly lower than 5.33% (4.45%, 9.17%) in the normal liver function group. The absolute values of CD3+ cells and CD3+CD8+ cells in the liver dysfunction group were 6 014 (5 077,11 164) cells/μL and 4 614 (3 220, 8 103) cells/μL, respectively, sig-nificantly higher than 4 798 (3 166,7 140) cells/μL and 2 962 (2 401, 4 918) cells/μL in the normal liver function group (P<0.05). Spearman correlation analysis results showed that serum ALT level was positively correlated with the absolute values of CD3+ cells and CD3+CD8+T cells (r=0.34, 0.31, P=0.007, 0.015).Conclusions Peripheral blood lymphocyte subset determination plays an important srole in evaluating IM in children with liver function abnormalities. Monitoring the changes in the percentage and count of lymphocytesubset indicators can provide a basis for early clinical diagnosis, reduce the occurrence of complications, and improve prognosis. |
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