摘要
目的研究巨细胞病毒(CMV)感染肾损伤患儿T淋巴细胞亚群变化及联合检测临床意义。方法选取2018年12月-2020年12月于保定市儿童医院收治的60例CMV感染患儿作为病例组,根据肾功能情况将其分为肾损伤组(n=38)和肾功能正常组(n=22),另选同期体检健康幼儿30名作为对照组,采用流式细胞术检测T淋巴细胞亚群计数,比较两组及不同肾功能患儿的T淋巴细胞亚群计数,采用受试者工作特征(ROC)曲线分析T淋巴细胞亚群及联合检测对CMV感染肾损伤的诊断价值,采用logistics回归分析影响CMV感染患儿肾损伤的因素。结果病例组患儿的CD3^(+)T、CD4^(+)T和CD4^(+)/CD8^(+)水平低于对照组,而CD8^(+)T高于对照组,差异均有统计学意义(P均<0.05)。肾损伤组患儿的CD3^(+)T、CD4^(+)T和CD4^(+)/CD8^(+)水平低于肾功能正常组,而CD8^(+)T高于肾功能正常组,差异均有统计学意义(P均<0.05)。CD3^(+)T、CD4^(+)T、CD8^(+)T及CD4^(+)/CD8^(+)比值联合检测诊断CMV感染肾损伤的曲线下面积(AUC)为0.929,高于CD3^(+)T、CD4^(+)T、CD8^(+)T、CD4^(+)/CD8^(+)单一诊断的0.760、0.764、0.844、0.858,差异均有统计学意义(P均<0.05)。不同年龄、肝损伤、CD4^(+)/CD8^(+)水平的CMV感染患儿,其肾损伤发生情况比较,差异均有统计学意义(P均<0.05)。CD4^(+)/CD8^(+)水平是影响CMV感染患儿肾损伤的独立因素(OR=1.998),差异有统计学意义(P<0.05)。结论CMV感染患儿T淋巴细胞亚群失衡,可能是导致患儿肾损伤的危险因素,临床联合检测可提高其诊断效能。
Objective To study the changes of T lymphocyte subsets and the clinical significance of combined detection in children with renal injury induced by cytomegalovirus(CMV)infection.Methods Sixty children with CMV infection admitted to Baoding Children’s Hospital were enrolled as case group between December 2018 and December 2020.According to renal function status,they were divided into renal injury group(n=38)and normal renal function group(n=22).A total of 30 healthy children undergoing physical examination during the same period were enrolled as control group.The counts of T lymphocyte subsets were detected by flow cytometry,and which were compared between the two groups and in children with different renal function status.The diagnostic value of T lymphocyte subsets and their combination for renal injury induced by CMV infection was analyzed by receiver operating characteristic(ROC)curves.The influencing factors of renal injury were analyzed by logistics regression analysis.Results The levels of CD3^(+)T,CD4^(+)T and CD4^(+)/CD8^(+)in case group were lower than those in control group,while CD8^(+)T level was higher than that in control group(P all<0.05).The levels of CD3^(+)T,CD4^(+)T and CD4^(+)/CD8^(+)in renal injury group were lower than those in normal renal function group,while CD8^(+)T level was higher than that in normal renal function group(P all<0.05).Area under curve(AUC)of CD3^(+)T,CD4^(+)T,CD8^(+)T and CD4^(+)/CD8^(+)combined detection in the diagnosis of renal injury was 0.929,greater than that of CD3^(+)T,CD4^(+)T,CD8^(+)T and CD4^(+)/CD8^(+)alone(0.760,0.764,0.844,0.858,P all<0.05).The differences in the incidence of renal injury among CMV infection children with different age,liver injury status and CD4^(+)/CD8^(+)level were statistically significant(P all<0.05).CD4^(+)/CD8^(+)level(OR=1.998)was an independent influencing factor of renal injury in children with CMV infection(P<0.05).Conclusion sThe imbalance of T lymphocyte subsets might be a risk factor of renal injury in children with CMV infection.Clinically,combined detection could improve the diagnostic efficiency.
作者
蒋婷婷
毕晶
甄炜娜
JIANG Ting⁃ting;BI Jing;ZHEN Wei⁃na(Department of Infectious Diseases,Baoding Key Laboratory of Accurate Diagnosis and Treatment of Children Infectious Diseases,Baoding Children's Hospital,Baoding,Hebei 071000,China)
出处
《热带医学杂志》
CAS
2022年第12期1688-1691,1755,共5页
Journal of Tropical Medicine
基金
福棠儿童科学基金(FTCSF-2018-01)
作者简介
蒋婷婷(1985-),女,本科,主治医师,研究方向:儿科感染;通信作者:毕晶,E⁃mail:1459976111@qq.com
