重组人干扰素α1b注射液对儿童病毒性脑炎细胞免疫功能影响的研究

发布时间：2018-03-22 16:48

本文选题：病毒性脑炎　切入点：淋巴细胞亚群　出处：《河北医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本研究观察病毒性脑炎患儿外周血T淋巴细胞亚群的变化趋势,探究病毒性脑炎的细胞免疫状况;观察并分析辅以重组人干扰素α1b注射液联合治疗后,病毒性脑炎患儿的细胞免疫功能的变化,为临床治疗病毒性脑炎提供参考依据。方法:选取在河北医科大学第二医院儿内科于2015年12月至2016年11月住院并确诊为病毒性脑炎的患儿及年龄性别相匹配的健康体检儿童为研究对象,其中对照组为健康体检儿童共45例,年龄1岁-12岁,男生26例,女生19例。治疗组为确诊为病毒性脑炎患儿共60例,年龄2岁-13岁,男生34例,女生26例。将治疗组采用随机数字表法分为两组:A组(干扰素治疗组)及B组(常规治疗组):A组30例,年龄3-13岁,女14例,男16例;B组30例,年龄2~12岁,女12例,男18例。A组在基础治疗上辅以重组人干扰素α1b注射液联合治疗,B组在入院后给予常规抗病毒及对症支持治疗,所有病毒性脑炎患儿(发病5天内)均在入院48小时内及经治疗1周后采集外周静脉血3ml,健康体检儿童于门诊采取外周静脉血3ml,采用流式细胞术检测外周血淋巴细胞亚群(CD4+/CD8+,CD8+,CD4+,CD3+)。采用SPSSl7.0统计软件进行统计分析,结果用均数±标准差表示,两组间比较用t检验,以P0.05记为有统计学意义。结果:1治疗组治疗前与对照组外周T细胞亚群相比较存在差异,治疗组治疗前CD3+T细胞、CD4+T细胞、CD4+/CD8+水平较对照组均有所降低(P0.05),CD8+T细胞水平较对照组有所升高(P0.05)。2干扰素治疗组CD3+T细胞、CD4+T细胞、CD4+/CD8+水平治疗后较治疗前均有所升高(P0.05),CD8+T细胞水平较治疗前降低(P0.05);常规治疗组CD3+T细胞、CD4+T细胞水平治疗后较治疗前均有所升高(P0.05),而CD8+T细胞及CD4+/CD8+水平治疗后较治疗前无差异(P0.05)。3干扰素治疗组CD3+T细胞、CD4+T细胞、CD8+T细胞、CD4+/CD8+治疗前水平较常规治疗组治疗前水平无差异(P0.05);干扰素治疗组CD3+T细胞、CD4+T细胞、CD4+/CD8+治疗后水平较常规治疗组治疗后水平显著升高(P0.05),而CD8+细胞治疗后水平较常规治疗组显著下降。结论:病毒性脑炎患儿的细胞免疫功能发生变化,CD3+T细胞、CD4+T细胞、CD4+/CD8+水平较对照组有所下降,说明机体的细胞免疫功能呈抑制状态,而经治疗后患儿的细胞免疫功能都有所改善,辅以重组人干扰素α1b注射液治疗使病毒性脑炎患儿的细胞免疫功能得到显著的改善,因此重组人干扰素α1b注射液值得在临床工作中推广应用。
[Abstract]:Objective: to observe the change trend of T lymphocyte subsets in peripheral blood of children with viral encephalitis, to explore the cellular immunity of viral encephalitis, to observe and analyze the effect of recombinant human interferon 伪 1b injection in combination therapy. Changes of cellular immune function in children with viral encephalitis, To provide reference for clinical treatment of viral encephalitis. Methods: select the children who were hospitalized from December 2015 to November 2016 and diagnosed with viral encephalitis in Department of Pediatrics, the second Hospital of Hebei Medical University, and age and gender matched health. Health check-up children were studied. The control group consisted of 45 healthy children aged 1-12 years, 26 boys and 19 girls, 60 children with viral encephalitis, aged 2-13 years, and 34 boys in the treatment group. 26 female students were randomly divided into two groups: group A (interferon treatment group) and group B (routine treatment group: group A: 30 cases, age 3-13 years, female: 14 cases, male: 16 cases, group B: 30 cases, age: 212 years, female: 12 cases). Group A was treated with recombinant human interferon 伪 1b injection combined with recombinant human interferon 伪 1b injection. Group B was treated with routine antiviral therapy and symptomatic support therapy after admission. All children with viral encephalitis (within 5 days of onset) collected 3 ml of peripheral venous blood within 48 hours of admission and 1 week after treatment. The healthy children took 3 ml of peripheral venous blood in outpatient clinic. Flow cytometry was used to detect the peripheral blood lymphoid. The subsets of CD4 / CD8, CD8, CD4 and CD3 were analyzed by SPSSl7.0 software. Results there was significant difference between the two groups in terms of mean 卤standard deviation (mean 卤standard deviation) and t test (P0.05). Results there was significant difference in peripheral T cell subsets between the treatment group and the control group before treatment. The levels of CD4 / CD8 in CD3 T cells before treatment in the treatment group were lower than those in the control group. Compared with the control group, the level of P0.05T cells in the treatment group was higher than that in the control group. The levels of CD4 / CD8 in the CD3 T cell and CD4 / CD8 ratio in the interferon treatment group were higher than those in the control group. The levels of CD3 T cells and CD4 T cells in the routine treatment group were higher than those before treatment, while the levels of CD8 T cells and CD4 / CD8 were not different from those before treatment. There was no difference in the level of CD4 / CD8 between CD3 T cells and CD4 / CD8 cells before treatment compared with that before treatment in the conventional treatment group, and the level of CD4 / CD8 in the interferon treatment group was significantly higher than that in the routine treatment group after treatment. Conclusion: the changes of cellular immune function of children with viral encephalitis and the level of CD4 / CD8 of CD3 T cells in children with viral encephalitis were lower than those in the control group. The results showed that the cellular immune function of the patients with viral encephalitis was inhibited, and the cellular immune function of the children with viral encephalitis was significantly improved by the treatment of recombinant human interferon 伪 1b injection. Therefore, recombinant human interferon 伪 1b injection is worth popularizing in clinical work.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R725.1

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