本文選題：病毒性腦炎　切入點(diǎn)：淋巴細(xì)胞亞群　出處：《河北醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:本研究觀察病毒性腦炎患兒外周血T淋巴細(xì)胞亞群的變化趨勢,探究病毒性腦炎的細(xì)胞免疫狀況;觀察并分析輔以重組人干擾素α1b注射液聯(lián)合治療后,病毒性腦炎患兒的細(xì)胞免疫功能的變化,為臨床治療病毒性腦炎提供參考依據(jù)。方法:選取在河北醫(yī)科大學(xué)第二醫(yī)院兒內(nèi)科于2015年12月至2016年11月住院并確診為病毒性腦炎的患兒及年齡性別相匹配的健康體檢兒童為研究對象,其中對照組為健康體檢兒童共45例,年齡1歲-12歲,男生26例,女生19例。治療組為確診為病毒性腦炎患兒共60例,年齡2歲-13歲,男生34例,女生26例。將治療組采用隨機(jī)數(shù)字表法分為兩組:A組(干擾素治療組)及B組(常規(guī)治療組):A組30例,年齡3-13歲,女14例,男16例;B組30例,年齡2~12歲,女12例,男18例。A組在基礎(chǔ)治療上輔以重組人干擾素α1b注射液聯(lián)合治療,B組在入院后給予常規(guī)抗病毒及對癥支持治療,所有病毒性腦炎患兒(發(fā)病5天內(nèi))均在入院48小時(shí)內(nèi)及經(jīng)治療1周后采集外周靜脈血3ml,健康體檢兒童于門診采取外周靜脈血3ml,采用流式細(xì)胞術(shù)檢測外周血淋巴細(xì)胞亞群(CD4+/CD8+,CD8+,CD4+,CD3+)。采用SPSSl7.0統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)分析,結(jié)果用均數(shù)±標(biāo)準(zhǔn)差表示,兩組間比較用t檢驗(yàn),以P0.05記為有統(tǒng)計(jì)學(xué)意義。結(jié)果:1治療組治療前與對照組外周T細(xì)胞亞群相比較存在差異,治療組治療前CD3+T細(xì)胞、CD4+T細(xì)胞、CD4+/CD8+水平較對照組均有所降低(P0.05),CD8+T細(xì)胞水平較對照組有所升高(P0.05)。2干擾素治療組CD3+T細(xì)胞、CD4+T細(xì)胞、CD4+/CD8+水平治療后較治療前均有所升高(P0.05),CD8+T細(xì)胞水平較治療前降低(P0.05);常規(guī)治療組CD3+T細(xì)胞、CD4+T細(xì)胞水平治療后較治療前均有所升高(P0.05),而CD8+T細(xì)胞及CD4+/CD8+水平治療后較治療前無差異(P0.05)。3干擾素治療組CD3+T細(xì)胞、CD4+T細(xì)胞、CD8+T細(xì)胞、CD4+/CD8+治療前水平較常規(guī)治療組治療前水平無差異(P0.05);干擾素治療組CD3+T細(xì)胞、CD4+T細(xì)胞、CD4+/CD8+治療后水平較常規(guī)治療組治療后水平顯著升高(P0.05),而CD8+細(xì)胞治療后水平較常規(guī)治療組顯著下降。結(jié)論:病毒性腦炎患兒的細(xì)胞免疫功能發(fā)生變化,CD3+T細(xì)胞、CD4+T細(xì)胞、CD4+/CD8+水平較對照組有所下降,說明機(jī)體的細(xì)胞免疫功能呈抑制狀態(tài),而經(jīng)治療后患兒的細(xì)胞免疫功能都有所改善,輔以重組人干擾素α1b注射液治療使病毒性腦炎患兒的細(xì)胞免疫功能得到顯著的改善,因此重組人干擾素α1b注射液值得在臨床工作中推廣應(yīng)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 偽 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 偽 1b injection combined with recombinant human interferon 偽 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 鹵standard deviation (mean 鹵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 偽 1b injection. Therefore, recombinant human interferon 偽 1b injection is worth popularizing in clinical work.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R725.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 方春艷;鄒小杰;袁哲峰;黃明海;高峰;;腸道病毒性腦炎的患兒T細(xì)胞活化亞群和細(xì)胞因子的變化[J];中華實(shí)驗(yàn)和臨床病毒學(xué)雜志;2016年02期

2 劉潔;;重組人干擾素α 1b治療小兒腺病毒肺炎療效分析[J];云南醫(yī)藥;2015年04期

3 王楠楠;;兒童肺炎支原體感染并發(fā)腦炎32例臨床分析[J];安徽醫(yī)藥;2014年04期

4 宮相翠;徐元芹;蔣艷;;EV71相關(guān)手足口病合并肺水腫的體液免疫作用[J];當(dāng)代醫(yī)學(xué);2012年28期

5 郭剛;;甲潑尼龍聯(lián)合丙種球蛋白治療單純皰疹病毒性腦炎的臨床觀察[J];山西醫(yī)藥雜志;2012年06期

6 莫揚(yáng);;手足口病危重型患兒淋巴細(xì)胞亞群及免疫球蛋白檢測[J];微循環(huán)學(xué)雜志;2011年04期

7 田瑛;張娟;王紅;;病毒感染患者抗病毒治療前后淋巴細(xì)胞亞群的變化及意義[J];臨床和實(shí)驗(yàn)醫(yī)學(xué)雜志;2011年18期

8 周海蘭;李華東;;EV71感染的手足口病患兒體液免疫臨床分析[J];中華實(shí)驗(yàn)和臨床感染病雜志(電子版);2011年02期

9 ;A Comparison of the Biological Characteristics of EV71 C4 Subtypes from Different Epidemic Strains[J];Virologica Sinica;2010年02期

10 侯立維;紀(jì)冬樺;李相文;;靜注免疫球蛋白治療重癥病毒性腦炎的體會(huì)[J];中國實(shí)用神經(jīng)疾病雜志;2009年13期

，

本文編號：1649522