兒童慢性鼻—鼻竇炎細(xì)胞免疫狀況的研究
發(fā)布時(shí)間：2018-08-07 09:18
【摘要】：目的本文通過(guò)探討兒童慢性鼻-鼻竇炎(chronic rhinosinusitis CRS)的外周血細(xì)胞免疫狀況與疾病本身的相關(guān)性,以期為制定更合理的臨床治療提供依據(jù),從而提高兒童CRS的治愈率及縮短療程。研究背景及方法兒童慢性鼻-鼻竇炎(chronic rhinosinusitis CRS)逐漸成為兒科的常見(jiàn)病及多發(fā)病。目前關(guān)于兒童CRS的發(fā)病機(jī)制研究尚未完全明確,當(dāng)前國(guó)內(nèi)有關(guān)研究都停留在鼻腔內(nèi)細(xì)菌的分布及鼻息肉中細(xì)胞因子及嗜酸性粒細(xì)胞等方面,關(guān)于兒童CRS外周血中細(xì)胞免疫狀況的研究尚少。本研究通過(guò)對(duì)2016年3月~2017年3月的門診就診的兒童慢性鼻—鼻竇炎(CRS)患者71例(實(shí)驗(yàn)組)、正常健康體檢兒童59例(對(duì)照組)的血清中CD4~+T細(xì)胞(Th)、CD8~+T細(xì)胞(Ts)、CD19~+B細(xì)胞、CD3~+T細(xì)胞、NK細(xì)胞及CD4~+/CD8~+比值進(jìn)行檢測(cè),應(yīng)用SPSS17.0統(tǒng)計(jì)軟件進(jìn)行分析,計(jì)數(shù)資料以率表示,組間比較采用χ~2檢驗(yàn),計(jì)量資料檢驗(yàn)前均進(jìn)行方差齊性和正態(tài)分布檢驗(yàn),正態(tài)分布的計(jì)量資料以均數(shù)±標(biāo)準(zhǔn)差表示,組間比較采用t檢驗(yàn),非正態(tài)分布的計(jì)量資料以中位數(shù)與四分位數(shù)間距表示,組間比較采用秩和檢驗(yàn),運(yùn)用Logistic多因素回歸分析判定疾病發(fā)生的影響因素,均以P0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果兒童慢性鼻-鼻竇炎組(CRS)總共有71例,其中男46例,女25例,平均年齡4.13±1.95歲;正常健康體檢兒童組總共有59例,其中男40例,女19例,平均年齡5.02±3.60歲,兩組別間年齡上采用t檢驗(yàn),結(jié)果t值=1.799,P=0.074,差異無(wú)統(tǒng)計(jì)學(xué)意義。兒童慢性鼻-鼻竇炎組和健康兒童組之間的性別采用卡方檢驗(yàn),χ~2=0.130,P=0.718,差異無(wú)統(tǒng)計(jì)學(xué)意義。兒童CRS組的CD4~+T細(xì)胞(Th)、CD3~+T細(xì)胞與健康兒童組比較差異無(wú)統(tǒng)計(jì)學(xué)意義。兒童CRS組的NK細(xì)胞低于健康兒童組(t=7.301,P=0.000,差異有統(tǒng)計(jì)學(xué)意義);兒童CRS組的CD8~+T細(xì)胞低于健康組(t=2.942,P=0.004,差異有統(tǒng)計(jì)學(xué)意義);CRS組的CD19~+B細(xì)胞高于健康兒童組(t=-7.828,P=0.000,差異具有統(tǒng)計(jì)學(xué)意義);兒童CRS組的CD4~+/CD8~+比值高于健康兒童組(t=-3.265,P=0.000,差異有統(tǒng)計(jì)學(xué)意義)。使用Logistic回歸分析對(duì)上述有統(tǒng)計(jì)學(xué)意義的指標(biāo)進(jìn)行分析,CD8~+T細(xì)胞的P=0.419,OR值=0.883,95%CI:0.653-1.194,CD4~+/CD8~+比值的結(jié)果:P=0.712,OR值=0.607,95%CI:0.043-8.650;表示CD8~+T細(xì)胞及CD4~+/CD8~+比值均不是CRS的獨(dú)立危險(xiǎn)因素。而NK細(xì)胞的分析結(jié)果是:P=0.008,OR值=0.799,95%CI:0.678-0.943,CD19~+B細(xì)胞的結(jié)果是:P=0.009,OR值=1.224,95%CI:1.052-1.423,表示NK細(xì)胞可能是兒童CRS的保護(hù)因子,而CD19~+B細(xì)胞則可能是兒童CRS的危險(xiǎn)因子。結(jié)論1.CRS患兒外周血CD4~+T細(xì)胞、CD3~+T細(xì)胞較健康兒童組無(wú)明顯差異;2.與健康兒童相比,CRS兒童的外周血NK細(xì)胞、CD8~+T細(xì)胞降低,CD19~+B細(xì)胞及CD4~+/CD8~+比值有升高;3.根據(jù)Logistic回歸分析結(jié)果,CD8~+T細(xì)胞及CD4~+/CD8~+比值不是CRS的獨(dú)立危險(xiǎn)因素,NK細(xì)胞減低及CD19~+B細(xì)胞升高均可能引起兒童CRS的發(fā)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.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R765
本文編號(hào)：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.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R765
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