大叶性肺炎患儿诱导痰中T细胞亚群和细胞因子的变化及意义

目的：研究大叶性肺炎患儿诱导痰中T细胞亚群和细胞因子的变化及其临床意义。方法选择2014年9月至2015年9月在我院儿科接受诊治的大叶性肺炎患儿64例作为观察组，另选同期在我院进行健康体检的健康儿童60例作为对照组，比较两组受检者诱导痰内的T细胞亚群(CD3+、CD4+、CD8+及CD4+/CD8+)，炎性细胞因子水平(IL-6、IL-8及TNF-α)，以及T细胞亚群有关细胞因子水平(IFN-γ、TGF-β及IL-17A)。结果观察组患儿的诱导痰内的CD3+(67.84±8.62)%、CD4+(46.08±6.93)%及CD4+/CD8+(2.07±0.21)均较对照组的(55.37±6.25)%、(30.82±5.07)%、(1.40±0.17)明显更高，差异均有统计学意义(P<0.05)；两组受检者的CD8+(24.23±3.06)%及(24.63±3.62)%比较，差异无统计学意义(P>0.05)；观察组患儿诱导痰内的IL-6(358.27±29.13) ng/L、IL-8(2.13±0.07) ng/L及TNF-α(3.08±0.92) ng/L水平均较对照组的(150.24±32.28) ng/L、(0.58±0.02) ng/L、(0.39±0.23) ng/L明显更高，差异均有统计学意义(P<0.05)；观察组患儿诱导痰内IFN-γ(5.19±2.63)×10-4及TGF-β(3.31±1.09)×10-2显著低于对照组的(23.42±3.92)×10-4及(6.18±2.11)×10-2，而IL-17A (3.46±1.24)×10-5显著高于对照组的(2.94±1.30)×10-5，差异均有统计学意义(P<0.05)。结论大叶性肺炎患儿诱导痰中的T细胞亚群以及细胞因子均呈现出异常变化，对此类指标进行监测有助于临床的诊断与治疗。

Change and significance of T lymphocyte subsets and cell factor in induced sputum in children with lobar pneumonia

Objective To study the change and clinical significance of T lymphocyte subsets and cell factor in induced sputum in children of lobar pneumonia. Methods From September 2014 to September 2015, 64 children with lobar pneumonia in Department of Pediatrics in our hospital were selected as the observation group, and 60 healthy chil-dren were enrolled as the control group. T lymphocyte subsets (CD3+, CD4+, CD8+and CD4+/CD8+), the levels of cyto-kines (IL-6, IL-8 and TNF-α), and cytokine levels (IFN-γ, TGF-βand IL-17A) in induced sputum were compared be-tween the two groups. Results CD3+, CD4+and CD4+/CD8+in the observation group were (67.84 ± 8.62)%, (46.08 ± 6.93)%, (2.07±0.21), which were significantly higher than those in the control group of (55.37±6.25)%, (30.82±5.07)%, (1.40 ± 0.17), and the differences were statistically significant (P<0.05). CD8+showed no statistically significant differ-ence between the two groups, (24.23±3.06)%vs (24.63±3.62)%, P>0.05. The levels of IL-6, IL-8 and TNF-αin the ob-servation group were (358.27 ± 29.13) ng/L, (2.13 ± 0.07) ng/L (3.08 ± 0.92)ng/L, which were significantly higher than those in the control group of (150.24±32.28) ng/L, (0.58±0.02) ng/L, (0.39±0.23) ng/L, with statistically significant dif-ference (P<0.05). IFN-γand TGF-βin the observation group were (5.19±2.63)×10-4 and (3.31±1.09)×10-2, which were significantly lower than those in the control group of (23.42±3.92)×10-4 and (6.18±2.11)×10-2, while the IL-17A was sig-nificantly higher in the observation group than the control group, (3.46±1.24)×10-5 vs (2.94±1.30)×10-5, with statistically significant difference (P<0.05). Conclusion In the induced sputum of children with lobar pneumonia, T cell subsets and cytokines show abnormal changes, and monitoring of the indicators is helpful to clinical diagnosis and treatment.