儿童慢性鼻—鼻窦炎细胞免疫状况的研究
发布时间：2018-08-07 09:18
【摘要】：目的本文通过探讨儿童慢性鼻-鼻窦炎(chronic rhinosinusitis CRS)的外周血细胞免疫状况与疾病本身的相关性,以期为制定更合理的临床治疗提供依据,从而提高儿童CRS的治愈率及缩短疗程。研究背景及方法儿童慢性鼻-鼻窦炎(chronic rhinosinusitis CRS)逐渐成为儿科的常见病及多发病。目前关于儿童CRS的发病机制研究尚未完全明确,当前国内有关研究都停留在鼻腔内细菌的分布及鼻息肉中细胞因子及嗜酸性粒细胞等方面,关于儿童CRS外周血中细胞免疫状况的研究尚少。本研究通过对2016年3月~2017年3月的门诊就诊的儿童慢性鼻—鼻窦炎(CRS)患者71例(实验组)、正常健康体检儿童59例(对照组)的血清中CD4~+T细胞(Th)、CD8~+T细胞(Ts)、CD19~+B细胞、CD3~+T细胞、NK细胞及CD4~+/CD8~+比值进行检测,应用SPSS17.0统计软件进行分析,计数资料以率表示,组间比较采用χ~2检验,计量资料检验前均进行方差齐性和正态分布检验,正态分布的计量资料以均数±标准差表示,组间比较采用t检验,非正态分布的计量资料以中位数与四分位数间距表示,组间比较采用秩和检验,运用Logistic多因素回归分析判定疾病发生的影响因素,均以P0.05为差异有统计学意义。结果儿童慢性鼻-鼻窦炎组(CRS)总共有71例,其中男46例,女25例,平均年龄4.13±1.95岁;正常健康体检儿童组总共有59例,其中男40例,女19例,平均年龄5.02±3.60岁,两组别间年龄上采用t检验,结果t值=1.799,P=0.074,差异无统计学意义。儿童慢性鼻-鼻窦炎组和健康儿童组之间的性别采用卡方检验,χ~2=0.130,P=0.718,差异无统计学意义。儿童CRS组的CD4~+T细胞(Th)、CD3~+T细胞与健康儿童组比较差异无统计学意义。儿童CRS组的NK细胞低于健康儿童组(t=7.301,P=0.000,差异有统计学意义);儿童CRS组的CD8~+T细胞低于健康组(t=2.942,P=0.004,差异有统计学意义);CRS组的CD19~+B细胞高于健康儿童组(t=-7.828,P=0.000,差异具有统计学意义);儿童CRS组的CD4~+/CD8~+比值高于健康儿童组(t=-3.265,P=0.000,差异有统计学意义)。使用Logistic回归分析对上述有统计学意义的指标进行分析,CD8~+T细胞的P=0.419,OR值=0.883,95%CI:0.653-1.194,CD4~+/CD8~+比值的结果:P=0.712,OR值=0.607,95%CI:0.043-8.650;表示CD8~+T细胞及CD4~+/CD8~+比值均不是CRS的独立危险因素。而NK细胞的分析结果是:P=0.008,OR值=0.799,95%CI:0.678-0.943,CD19~+B细胞的结果是:P=0.009,OR值=1.224,95%CI:1.052-1.423,表示NK细胞可能是儿童CRS的保护因子,而CD19~+B细胞则可能是儿童CRS的危险因子。结论1.CRS患儿外周血CD4~+T细胞、CD3~+T细胞较健康儿童组无明显差异;2.与健康儿童相比,CRS儿童的外周血NK细胞、CD8~+T细胞降低,CD19~+B细胞及CD4~+/CD8~+比值有升高;3.根据Logistic回归分析结果,CD8~+T细胞及CD4~+/CD8~+比值不是CRS的独立危险因素,NK细胞减低及CD19~+B细胞升高均可能引起儿童CRS的发生。
[Abstract]:Objective to explore the correlation between the peripheral blood cell immune status of children with chronic rhinosinusitis (chronic rhinosinusitis CRS) and the disease itself, in order to provide the basis for making more rational clinical treatment, so as to improve the cure rate and shorten the course of treatment of children's CRS, and to study the chronic rhinosinusitis (chronic rhinosin) in children and methods (chronic rhinosin) Usitis CRS) has gradually become a common and frequently occurring disease in pediatrics. At present, the research on the pathogenesis of CRS in children is not completely clear. At present, the domestic research on the bacterial distribution in the nasal cavity and the cytokine and eosinophil in the nasal polyps and so on. There are few studies on the cellular immune status in the peripheral blood of children's CRS. In this study, 71 children with chronic rhinosinusitis (CRS) in the outpatient clinic in March ~2017 March 2016 were studied. The serum CD4~+T cells (Th), CD8~+T cells (Ts), CD19~+B cells, CD3~+T cells, NK cells and CD4~+/CD8~+ ratios were detected in 59 normal healthy children (control group), and the SPSS17.0 statistical software was used. Analysis, the number of data is expressed as the rate, the group comparison uses the chi square ~2 test, the measurement data before the test of homogeneity of variance and normal distribution test, the normal distribution of the measurement data is expressed in the mean number of standard deviation, the group is compared with the t test, the measurement data of the non normal distribution is expressed by the median and four quantiles, and the ranks are compared with the rank sum. The Logistic multiple regression analysis was used to determine the factors affecting the occurrence of the disease, all of which were statistically significant in P0.05. Results there were 71 cases of chronic rhinosinusitis (CRS) in children, including 46 males and 25 females, with an average age of 4.13 + 1.95 years. There were 59 cases in normal healthy children, including 40 men and 19 women, with an average age of 5.. 02 + 3.60 years old, the age of two groups using t test, the results of T value =1.799, P=0.074, the difference is not statistically significant. The sex of children with chronic rhinosinusitis and healthy children between the chi square test, ~2=0.130, P=0.718, the difference between children, CRS group CD4~+ T cell (Th), CD3~+T cells and healthy children is no difference. Statistical significance. The NK cells in the children CRS group were lower than the healthy children group (t=7.301, P=0.000, and the difference was statistically significant); the CD8~+T cells in the CRS group of children were lower than the healthy group (t=2.942, P=0.004, the difference was statistically significant); the CD19~+B cells in the group CRS group were higher than those of the healthy children group (t =-7.828, the difference was statistically significant); The CD8~+ ratio was higher than that of the healthy children (t=-3.265, P=0.000, the difference was statistically significant). The Logistic regression analysis was used to analyze the above statistical indicators, the P=0.419 of CD8~+T cells, the OR value =0.883,95%CI:0.653-1.194, and the CD4~+/CD8~+ ratio results: P=0.712, OR =0.607,95%CI:0.043-8.650; The ratio of ~ + is not an independent risk factor for CRS, and the results of NK cell analysis are: P=0.008, OR value =0.799,95%CI:0.678-0.943, and the result of CD19~+B cells: P=0.009, OR value =1.224,95%CI:1.052-1.423, indicating that NK cells may be the protections of children CRS, and CD19~+B cells may be the risk factors for children. There was no significant difference in blood CD4~+T cells and CD3~+T cells from healthy children. 2. compared with healthy children, the peripheral blood NK cells, CD8~+T cells, CD19~+B cells and CD4~+/CD8~+ ratio increased in CRS children. 3. according to the Logistic regression analysis, CD8~+T cells and CD4~+/CD8~+ ratios were not the independent risk factors of CRS, and NK cells were reduced. The elevation of B cells may cause the occurrence of CRS in children.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R765
本文编号：2169572
[Abstract]:Objective to explore the correlation between the peripheral blood cell immune status of children with chronic rhinosinusitis (chronic rhinosinusitis CRS) and the disease itself, in order to provide the basis for making more rational clinical treatment, so as to improve the cure rate and shorten the course of treatment of children's CRS, and to study the chronic rhinosinusitis (chronic rhinosin) in children and methods (chronic rhinosin) Usitis CRS) has gradually become a common and frequently occurring disease in pediatrics. At present, the research on the pathogenesis of CRS in children is not completely clear. At present, the domestic research on the bacterial distribution in the nasal cavity and the cytokine and eosinophil in the nasal polyps and so on. There are few studies on the cellular immune status in the peripheral blood of children's CRS. In this study, 71 children with chronic rhinosinusitis (CRS) in the outpatient clinic in March ~2017 March 2016 were studied. The serum CD4~+T cells (Th), CD8~+T cells (Ts), CD19~+B cells, CD3~+T cells, NK cells and CD4~+/CD8~+ ratios were detected in 59 normal healthy children (control group), and the SPSS17.0 statistical software was used. Analysis, the number of data is expressed as the rate, the group comparison uses the chi square ~2 test, the measurement data before the test of homogeneity of variance and normal distribution test, the normal distribution of the measurement data is expressed in the mean number of standard deviation, the group is compared with the t test, the measurement data of the non normal distribution is expressed by the median and four quantiles, and the ranks are compared with the rank sum. The Logistic multiple regression analysis was used to determine the factors affecting the occurrence of the disease, all of which were statistically significant in P0.05. Results there were 71 cases of chronic rhinosinusitis (CRS) in children, including 46 males and 25 females, with an average age of 4.13 + 1.95 years. There were 59 cases in normal healthy children, including 40 men and 19 women, with an average age of 5.. 02 + 3.60 years old, the age of two groups using t test, the results of T value =1.799, P=0.074, the difference is not statistically significant. The sex of children with chronic rhinosinusitis and healthy children between the chi square test, ~2=0.130, P=0.718, the difference between children, CRS group CD4~+ T cell (Th), CD3~+T cells and healthy children is no difference. Statistical significance. The NK cells in the children CRS group were lower than the healthy children group (t=7.301, P=0.000, and the difference was statistically significant); the CD8~+T cells in the CRS group of children were lower than the healthy group (t=2.942, P=0.004, the difference was statistically significant); the CD19~+B cells in the group CRS group were higher than those of the healthy children group (t =-7.828, the difference was statistically significant); The CD8~+ ratio was higher than that of the healthy children (t=-3.265, P=0.000, the difference was statistically significant). The Logistic regression analysis was used to analyze the above statistical indicators, the P=0.419 of CD8~+T cells, the OR value =0.883,95%CI:0.653-1.194, and the CD4~+/CD8~+ ratio results: P=0.712, OR =0.607,95%CI:0.043-8.650; The ratio of ~ + is not an independent risk factor for CRS, and the results of NK cell analysis are: P=0.008, OR value =0.799,95%CI:0.678-0.943, and the result of CD19~+B cells: P=0.009, OR value =1.224,95%CI:1.052-1.423, indicating that NK cells may be the protections of children CRS, and CD19~+B cells may be the risk factors for children. There was no significant difference in blood CD4~+T cells and CD3~+T cells from healthy children. 2. compared with healthy children, the peripheral blood NK cells, CD8~+T cells, CD19~+B cells and CD4~+/CD8~+ ratio increased in CRS children. 3. according to the Logistic regression analysis, CD8~+T cells and CD4~+/CD8~+ ratios were not the independent risk factors of CRS, and NK cells were reduced. The elevation of B cells may cause the occurrence of CRS in children.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R765
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