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目的通过测定Tourette综合征(TS)患儿血清抗链球菌溶血素O(ASO)、T淋巴细胞亚群和自然杀伤细胞(NKC),观察链球菌感染与TS的关系、TS细胞免疫功能状态及免疫调节剂的治疗作用。方法2005-05—2005-10对首都儿研所神经科门诊就诊的58例TS患儿分别采用透射比浊法检测ASO,双色免疫荧光法检测T淋巴细胞亚群及NKC。以同期健康体检儿童为对照组。对细胞免疫异常者随机分为两组,分别予免疫调节剂或免疫调节剂+多巴胺受体阻滞剂治疗。结果(1)TS患儿ASO阳性率较对照组显著增高(P<0.05);(2)TS患儿中,ASO阳性组CD4+显著低于ASO阴性组(P<0.05);TS患儿CD3+、CD4+、CD4+/CD8+显著低于对照组(P均<0.05),NKC显著高于对照组(P<0.05);(3)细胞免疫异常的TS患儿,单纯采用免疫调节剂治疗或免疫调节剂+多巴胺受体阻滞剂治疗,两组间疗效差异无显著性(P>0.05)。结论部分TS患儿发病与链球菌感染有关;TS患儿存在细胞免疫功能改变,表现为T淋巴细胞亚群平衡失调和NKC升高,链球菌感染可能与之有关;单纯免疫调节剂治疗可能对链球菌感染触发的TS有效。
Objective To investigate the relationship between the streptococcal infection and TS, the immune function status of TS and the relationship between the streptococcal infection and TS in children with Tourette’s syndrome (TS) Therapeutic effects of immunomodulators. Methods From 2005-05-2005-10, 58 children with TS undergoing neurological outpatient visits at Capital Institute of Gynecology and Obstetrics were tested by transmission turbidimetry for detecting ASO. T lymphocyte subsets and NKC were detected by two - color immunofluorescence. The same period, healthy children as a control group. Patients with abnormal cellular immunity were randomly divided into two groups, respectively, immunomodulator or immunomodulator + dopamine receptor blocker treatment. Results (1) The positive rate of ASO in children with TS was significantly higher than that in control group (P <0.05). (2) The percentage of CD4 + in ASO positive group was significantly lower than that in ASO negative group (P <0.05) CD4 +, CD4 + / CD8 + were significantly lower than those in the control group (all P <0.05), NKC was significantly higher than that in the control group (P <0.05); (3) TS children with abnormal cellular immunity were treated with immunomodulator or immunomodulator + Dopamine receptor blocker treatment, no significant difference between the two groups (P> 0.05). CONCLUSIONS: The incidence of TS in some children is related to streptococcal infection. There is a change in cellular immune function in children with TS, showing imbalance of T lymphocyte subsets and elevation of NKC, and may be related to streptococcal infection. Treatment with simple immunomodulatory agents may be related to TS triggered by streptococcal infection is effective.