目的：通过对儿童传染性单核细胞增多症（ IM）外周血淋巴细胞亚群的检测，探讨患儿细胞免疫功能变化与疾病的关系。方法采用流式细胞仪对40例观察组IM患儿外周血T、B和自然杀伤淋巴细胞亚群进行检测，以30例健康儿童作为对照组；同时对观察组患儿中的10例进行治疗2周后T细胞亚群的测定以观察动态变化情况。结果 IM患儿CD3、CD8 T淋巴细胞水平明显升高（t值分别为10．52、13．48，均P＜0．05）；CD19、CD4和CD4/CD8值水平明显降低，分别与正常对照组比较差异均有统计学意义（t值分别为-11．05、-15．16、-13．02，均P＜0．05）；自然杀伤细胞无明显变化（t＝-0．37，P＞0．05）。10例IM患儿治疗2周后，CD4、CD4/CD8值均高于治疗前，差异均有统计学意义（t值分别为-2．39、-2．21，均P＜0．05）；CD8值低于治疗前，差异有统计学意义（t＝4．57，P＜0．05）；治疗前CD3、CD19和自然杀伤细胞值与治疗后比较差异均无统计学意义（t值分别为1．43、-1．25、-0．53，均P＞0．05）。结论检测淋巴细胞亚群对评估IM患儿的细胞免疫状况、辅助诊断和指导治疗具有重要的临床价值。%Objecfive To investigate the relationship between cellular immune function and disease by detecting the changes of peripheral blood lymphocyte subtypes in children with infectious mononucleosis ( IM) .Methods T, B and NK lymphoctyte subsets in peripheral blood of 40 children with IM in observation group and 30 normal children in control group were measured by flow cytometry .The level of T lymphocyte subsets of 10 cases was measured two weeks after treatment in order to explore the dynamic changes .Results Compared with normal children,the levels of CD3 and CD8 cells increased significantly (t value was 10.52 and 13.48, respectively, both P<0.05) and the levels of CD19, CD4 and the ratio of CD4/CD8 were significantly lower in children with IM ( t value was -11.05, -15.16 and-13.02, respectively, all P<0.05).The levels of NK cells were not significantly different (t=-0.37, P>0.05).After two weeks of treatment, the levels of CD4 and CD4/CD8 ratio were significantly higher in 10 cases of IM (t value was -2.39 and -2.21 respectively, both P<0.05), and the level of CD8 was significantly lower (t=4.57, P<0.05).The levels of CD3, CD19 and NK cells were not significantly different after treatment (t value was 1.43, -1.25 and -0.53, respectively, all P>0.05).Conclusion The lymphocyte subtypes in peripheral blood is significant for evaluation of cellular immune function , auxiliary diagnosis and therapy in children with IM .
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