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目的探讨共刺激分子CD40/CD40L在儿童慢性活动性EB病毒感染(CAEBV)发病机制中的作用。方法选择30例EB病毒(EBV)感染患儿,其中CAEBV患儿、传染性单核细胞增多症(IM)患儿各15例;另选择15例健康儿童作为健康对照组。应用反转录-PCR检测EBV感染患儿及健康儿童外周血单个核细胞(PBMC)CD40mRNA和CD40L mRNA的表达量;应用流式细胞仪检测EBV感染患儿及健康儿童外周血淋巴细胞亚群的变化。结果 1.CAEBV组PBMC CD40mRNA及CD40L mRNA表达量明显升高,与健康对照组及IM组比较差异均有统计学意义(Pa<0.05);IM组PBMC CD40mRNA、CD40L mRNA表达量与健康对照组比较差异均无统计学意义(Pa>0.05)。2.CAEBV组外周血CD3+、CD8+、CD19+CD23+、CD16+56+淋巴细胞明显升高,CD4+、CD4+/CD8+淋巴细胞明显降低,与健康对照组比较差异均有统计学意义(Pa<0.05),与IM组比较差异均无统计学意义(Pa>0.05);IM组外周血CD3+、CD8+、CD19+CD23+、CD16+56+明显升高,CD4+、CD4+/CD8+明显降低,与健康对照组比较差异均有统计学意义(Pa<0.05)。结论共刺激分子CD40/CD40L异常表达及淋巴细胞功能紊乱参与CAEBV的发病,存在免疫功能障碍是CAEBV发病的主要原因之一。
Objective To investigate the role of costimulatory molecule CD40 / CD40L in the pathogenesis of chronic active Epstein-Barr virus (CAEBV) infection in children. Methods Thirty children with Epstein-Barr virus (EBV) infection were selected, including 15 children with CAEBV infection and 15 infectious children with infectious mononucleosis (IM). Another 15 healthy children were selected as healthy control group. The expression of CD40mRNA and CD40L mRNA in peripheral blood mononuclear cells (PBMCs) from children with EBV infection and healthy children was detected by reverse transcription-PCR. The peripheral blood lymphocyte subsets of children with EBV infection and healthy children were detected by flow cytometry Variety. Results 1. The expressions of CD40mRNA and CD40L mRNA in PBMC of CAEBV group were significantly higher than those of healthy control group and IM group (Pa <0.05). Compared with healthy control group, the expressions of CD40mRNA and CD40L mRNA in PBMC of IM group There was no significant difference (Pa> 0.05). The levels of CD3 +, CD8 +, CD19 + CD23 +, CD16 + 56 + lymphocytes in CAEBV group were significantly higher than those in control group (P <0.05). The levels of CD4 +, CD4 + / CD8 + lymphocytes in CAEBV group were significantly lower than those in healthy control group , But there was no significant difference compared with IM group (Pa> 0.05). The levels of CD3 +, CD8 +, CD19 + CD23 + and CD16 + 56 + in peripheral blood in IM group were significantly increased and CD4 +, CD4 + / CD8 + The differences were statistically significant (Pa <0.05). Conclusions Abnormal CD40 / CD40L expression and lymphocyte dysfunction are involved in the pathogenesis of CAEBV. Immune dysfunction is one of the major causes of CAEBV.