自身免疫性脑炎患儿外周血T淋巴细胞亚群、红细胞免疫及血浆游离氨基酸的表达水平及临床意义
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摘要
目的探讨自身免疫性脑炎患儿外周血T淋巴细胞亚群、红细胞免疫及血浆游离氨基酸水平。方法回顾性选取2017年1月至2018年12月期间确诊的自身免疫性脑炎患儿36例作为研究对象并归纳为患病组,同时选取同一期间在广州市妇女儿童医疗中心进行健康体检且结果健康的38例儿童作为健康组;详细记录两组成员的外周血T淋巴细胞亚群指标(CD3~+、CD8~+、CD4~+、CD4~+/CD8~+)、红细胞免疫指标[红细胞免疫C3b受体(RBC-C3bR)、红细胞免疫复合物(RBC-ICR)、红细胞免疫亲和力受体(FEER)]、血浆游离氨基酸指标(色氨酸、亮氨酸、赖氨酸、苯丙氨酸、γ-氨基丁酸)检测结果,并比较两组之间的差异。结果两组的外周血T淋巴细胞亚群指标对比发现,患病组的CD3~+、CD4~+、CD4~+/CD8~+水平明显低于健康组,患病组的CD8~+水平显著高于健康组,差异有统计学意义(P <0. 05);两组的红细胞免疫指标比较发现,患病组的RBC-C3bR水平明显低于健康组,患病组的RBC-ICR、FEER水平明显高于健康组,差异有统计学意义(P <0. 05);两组的血浆游离氨基酸水平指标比较发现,患病组的色氨酸、亮氨酸、赖氨酸、苯丙氨酸、γ-氨基丁酸水平均低于健康组,差异有统计学意义(P <0. 05)。结论自身免疫性脑炎患儿的外周血T淋巴细胞亚群、红细胞免疫及血浆离氨基酸水平具有的相关性变化,上述结果为自身免疫性脑炎患儿诊疗提供了新思路。
Objective To investigate the T lymphocyte subsets,erythrocyte immunity and plasma free amino acid levels in peripheral blood of children with autoimmune encephalitis. Methods Thirty-six children with autoimmune encephalitis diagnosed in our hospital from January 2017 to January 2018 were selected as the study subjects and classified into the disease group. Thirty-eight healthy children who underwent physical examination during the same period were selected as the healthy group. Subgroup indices( CD3~+,CD8~+,CD4~+,CD4~+/CD8~+),red blood cell immune indices( RBC-C3 bR,RBC-ICR,FEER),plasma free amino acid indices( tryptophan,leucine,lysine,phenylalanine,gamma-aminobutyric acid) were detected,and the differences between the two groups were compared. Results The level of CD3~+,CD4~+,CD4~+/CD8~+in the disease group was significantly lower than that in the healthy group( P < 0. 05),and the level of CD8 ~+ in the disease group was significantly higher than that in the healthy group( P < 0. 05). The RBC-C3 bR level of the disease group was significantly lower than that of the healthy group( P < 0. 05),and the RBC-ICR and FEER levels of the disease group were significantly higher than that of the healthy group( P < 0. 05). The levels of serum free amino acids in the two groups were significantly lower than those in the healthy group( P < 0. 05).Conclusion The correlative changes of peripheral blood T lymphocyte subsets,erythrocyte immunity and plasma free amino acid levels in children with autoimmune encephalitis provide new ideas for the diagnosis and treatment of children with autoimmune encephalitis.
Objective To investigate the T lymphocyte subsets,erythrocyte immunity and plasma free amino acid levels in peripheral blood of children with autoimmune encephalitis. Methods Thirty-six children with autoimmune encephalitis diagnosed in our hospital from January 2017 to January 2018 were selected as the study subjects and classified into the disease group. Thirty-eight healthy children who underwent physical examination during the same period were selected as the healthy group. Subgroup indices( CD3~+,CD8~+,CD4~+,CD4~+/CD8~+),red blood cell immune indices( RBC-C3 bR,RBC-ICR,FEER),plasma free amino acid indices( tryptophan,leucine,lysine,phenylalanine,gamma-aminobutyric acid) were detected,and the differences between the two groups were compared. Results The level of CD3~+,CD4~+,CD4~+/CD8~+in the disease group was significantly lower than that in the healthy group( P < 0. 05),and the level of CD8 ~+ in the disease group was significantly higher than that in the healthy group( P < 0. 05). The RBC-C3 bR level of the disease group was significantly lower than that of the healthy group( P < 0. 05),and the RBC-ICR and FEER levels of the disease group were significantly higher than that of the healthy group( P < 0. 05). The levels of serum free amino acids in the two groups were significantly lower than those in the healthy group( P < 0. 05).Conclusion The correlative changes of peripheral blood T lymphocyte subsets,erythrocyte immunity and plasma free amino acid levels in children with autoimmune encephalitis provide new ideas for the diagnosis and treatment of children with autoimmune encephalitis.
引文
[1]张轶凡.自身免疫性脑炎(AE)临床鉴别诊断及治疗分析[J].中国继续医学教育,2017,9(16):105-107.
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[3] Guan HZ,Ren HT,Cui LY. Autoimmune encephalitis:an expanding frontier of neuroimmunology[J]. Chin Med J(Engl),2016,129(9):1122-1127.
[4] Davies G,Irani SR,Cohart C,et a1. Anti-N-methyl-D-aspartate receptor antibodies:a potentially treatable cause of encephalitis in the intensive care unit[J]. Crit Care Med,2010,38(2):679-682.
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[8]陈向军,邓波.自身免疫性脑炎的诊断标准及其临床指导意义[J].中国临床神经科学,2016,24(3):336-340.
[9]樊森,张霞,郑帼,等.儿童自身免疫性脑炎的诊疗进展[J].临床神经病学杂志,2018,31(4):307-309.
[10] Granerod J,Ambrose HE,Davies NW,et al. Causes of encephalitis and differences in their clinical presentations In England:a multicentre,populaion-based prospective study[J]. LanetI nfect Dis,2010,10(12):835-844.
[11] Wright S,Hacohen Y,Jacobson L,et al. N-methyl-D-aspartate receptor antibody-mediated neurologicaldisease:Results of a UKbased surveillance study in children[J]. Arch Dis Child,2015,100(6):521-526.
[12]刘圣烜,邹标,李雪松,等.急性腹泻患儿外周血T淋巴细胞亚群分布及相关细胞因子的变化及意义[J].临床和实验医学杂志,2018,17(13):1384-1387.
[13]马丽娟,周林.儿童微量元素的检测及其价值分析[J].中华检验医学杂志,2016,39(4):240-242.
[14]叶慧明.不同锌制剂辅助治疗婴幼儿轮状病毒腹泻疗效及免疫功能影响分析[J].中国妇幼保健,2016,31(14):2875-2877.
[15] Guan SZ,Liu JW,Fang EF,et al. Chronic unpredictabie mild stress impairs erythrocyte Immune function and changes Tlymphocyte subsets in a rat model of stress-induced depression[J]. Environ Toxicol Pharacol,2014,37(1):414-422.
[16] Yang M,Ding J,Zhou X,et al. Effects of lycium barbarum polysaccharides on neuropeptide Y and heat-shock protein 70 expression in rats exposed to heat[J]. Biomedical Reports,2014,2(5):687-692.
[17] Sun YN,Liu YJ,Zhang L,et al. Expression of Organic Anion Transporting Polypeptide 1c1 and Monocarboxylate Transporter 8 in the Rat Placental Barrier and the Compensatory Response to Thyroid Dysfunction[J]. PLo S One,2014,9(4):e96047.
[18]范丽,付胡海.胎盘多肽对病毒性脑炎患儿外周血T细胞亚群及红细胞免疫指标的影响研究[J].安徽医药,2016,20(6):1201-1203.
[19]范小颖.自身免疫性脑炎患儿免疫水平的变化[D].石家庄:河北医科大学,2014.
[20] Tientcheu LD,Sutherland JS,de Jong BC,et al. Differences in T-cell responses between Mycobacterium tuberculosis and Mycobacterium africanum-infected patients[J]. Eur J Immunol,2014,44(5):1387-1398.
[2]李春,黄波,韦朝阳.自身免疫性脑炎发病机制研究新进展[J].当代医学,2018,24(12):185-186.
[3] Guan HZ,Ren HT,Cui LY. Autoimmune encephalitis:an expanding frontier of neuroimmunology[J]. Chin Med J(Engl),2016,129(9):1122-1127.
[4] Davies G,Irani SR,Cohart C,et a1. Anti-N-methyl-D-aspartate receptor antibodies:a potentially treatable cause of encephalitis in the intensive care unit[J]. Crit Care Med,2010,38(2):679-682.
[5] Suh-Lailam BB,Haven TR,Copple SS,et al. Anti-NMDA-receptor antibody encephalitis:performance evaluation and laboratory experience with the mati-NMDA-receptor Ig G assay[J]. Clin Chim Acta,2013,421:1-6.
[6]中华医学会神经病学分会.中国自身免疫性脑炎诊治专家共识[J].中华神经科杂志,2017,50(2):91-98.
[7] Davies E,Connolly DJ,Mordekar SR. Encephalopathy in children:An approach to assessment and management[J]. Arch Dis Child,2012,97(5):452-458.
[8]陈向军,邓波.自身免疫性脑炎的诊断标准及其临床指导意义[J].中国临床神经科学,2016,24(3):336-340.
[9]樊森,张霞,郑帼,等.儿童自身免疫性脑炎的诊疗进展[J].临床神经病学杂志,2018,31(4):307-309.
[10] Granerod J,Ambrose HE,Davies NW,et al. Causes of encephalitis and differences in their clinical presentations In England:a multicentre,populaion-based prospective study[J]. LanetI nfect Dis,2010,10(12):835-844.
[11] Wright S,Hacohen Y,Jacobson L,et al. N-methyl-D-aspartate receptor antibody-mediated neurologicaldisease:Results of a UKbased surveillance study in children[J]. Arch Dis Child,2015,100(6):521-526.
[12]刘圣烜,邹标,李雪松,等.急性腹泻患儿外周血T淋巴细胞亚群分布及相关细胞因子的变化及意义[J].临床和实验医学杂志,2018,17(13):1384-1387.
[13]马丽娟,周林.儿童微量元素的检测及其价值分析[J].中华检验医学杂志,2016,39(4):240-242.
[14]叶慧明.不同锌制剂辅助治疗婴幼儿轮状病毒腹泻疗效及免疫功能影响分析[J].中国妇幼保健,2016,31(14):2875-2877.
[15] Guan SZ,Liu JW,Fang EF,et al. Chronic unpredictabie mild stress impairs erythrocyte Immune function and changes Tlymphocyte subsets in a rat model of stress-induced depression[J]. Environ Toxicol Pharacol,2014,37(1):414-422.
[16] Yang M,Ding J,Zhou X,et al. Effects of lycium barbarum polysaccharides on neuropeptide Y and heat-shock protein 70 expression in rats exposed to heat[J]. Biomedical Reports,2014,2(5):687-692.
[17] Sun YN,Liu YJ,Zhang L,et al. Expression of Organic Anion Transporting Polypeptide 1c1 and Monocarboxylate Transporter 8 in the Rat Placental Barrier and the Compensatory Response to Thyroid Dysfunction[J]. PLo S One,2014,9(4):e96047.
[18]范丽,付胡海.胎盘多肽对病毒性脑炎患儿外周血T细胞亚群及红细胞免疫指标的影响研究[J].安徽医药,2016,20(6):1201-1203.
[19]范小颖.自身免疫性脑炎患儿免疫水平的变化[D].石家庄:河北医科大学,2014.
[20] Tientcheu LD,Sutherland JS,de Jong BC,et al. Differences in T-cell responses between Mycobacterium tuberculosis and Mycobacterium africanum-infected patients[J]. Eur J Immunol,2014,44(5):1387-1398.