826例0岁至学龄前健康儿童外周血淋巴细胞亚群分布的调查分析
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摘要
目的调查分析0岁至学龄前健康儿童外周血淋巴细胞亚群的分布。方法 826例0岁至学龄前汉族儿童分为新生儿组、婴儿组、幼儿组、学龄前组,使用流式细胞术检测各组外周血淋巴细胞亚群。结果 CD3~+细胞、CD3~+CD4~+细胞、CD3~-CD19~+细胞和CD4~+/CD8~+在0岁至学龄前儿童不同性别之间的差异具有统计学意义(P<0.05),CD3~-CD19~+细胞以女童较低,其他3个指标以女童较高;CD3~+、CD3~+CD4~+及CD4~+/CD8~+均以新生儿组最高,其中CD3~+CD4~+及CD4~+/CD8~+含量随年龄增长逐渐降低,至学龄前最低(P<0.05);CD3~-CD19~+和CD3~-CD16~+CD56~+细胞含量以新生儿组最低,随年龄增长而增高,CD3~-CD16~+CD56~+细胞以学龄前组最高,而CD3~-CD19~+细胞含量在幼儿期达峰值后降低(P<0.05);CD3~+CD8~+细胞含量以学龄前组最高(P<0.05)。不同年龄组男童的淋巴细胞亚群分布的变化趋势与不同年龄组儿童的规律一致;在女童中,CD3~+CD4~+及CD4~+/CD8~+含量也是以新生儿组最高(P<0.05)。结论淋巴细胞亚群在不同年龄、性别健康儿童之间的分布不同,建议按年龄、性别分别建立参考值。
Objective To study the distribution of peripheral blood lymphocyte subsets in healthy children aged 0-6 years. Methods A total of 826 healthy Han children aged 0-6 years were recruited. According to their age, the children were divided into four groups: newborn, infant, toddler and preschool. Their peripheral blood samples were collected to measure the percentages of lymphocyte subsets by flow cytometry. Results There were significant differences in the percentages of CD3~+ T cells, CD3~+CD4~+ T cells and CD3~-CD19~+ B cells and the CD4~+/CD8~+ ratio between boys and girls(P<0.05). The girls had a lower percentage of CD3~-CD19~+ B cells, higher percentages of CD3~+ T cells and CD3~+CD4~+ T cells and a higher CD4~+/CD8~+ ratio than the boys. The newborn group had the highest percentages of CD3~+ T cells and CD3~+CD4~+ T cells and the highest CD4~+/CD8~+ ratio(P<0.05). The percentage of CD3~+CD4~+ T cells and the CD4~+/CD8~+ ratio gradually decreased with age and the preschool group had the lowest values(P<0.05). The newborn group had the lowest percentages of CD3~-CD19~+ B cells and CD3~-CD16~+CD56~+ NK cells(P<0.05). The percentage of CD3~-CD16~+CD56~+ NK cells gradually increased with age and the preschool group had the highest percentage(P<0.05). The percentage of CD3~-CD19~+ B cells reached the peak in the toddler period and then decreased with age(P<0.05). The preschool group had the highest percentage of CD3~+CD8~+ T cells(P<0.05). The variation trend of distribution of lymphocyte subsets in boys from different age groups was consistent with that in children from different age groups. For girls, the newborn group had the highest percentage of CD3~+CD4~+ T cells and CD4~+/CD8~+ ratio(P<0.05). Conclusions The distribution of peripheral blood lymphocyte subsets in healthy children is significantly different across ages and sexes. Therefore, the reference values should be established according to age and sex.
Objective To study the distribution of peripheral blood lymphocyte subsets in healthy children aged 0-6 years. Methods A total of 826 healthy Han children aged 0-6 years were recruited. According to their age, the children were divided into four groups: newborn, infant, toddler and preschool. Their peripheral blood samples were collected to measure the percentages of lymphocyte subsets by flow cytometry. Results There were significant differences in the percentages of CD3~+ T cells, CD3~+CD4~+ T cells and CD3~-CD19~+ B cells and the CD4~+/CD8~+ ratio between boys and girls(P<0.05). The girls had a lower percentage of CD3~-CD19~+ B cells, higher percentages of CD3~+ T cells and CD3~+CD4~+ T cells and a higher CD4~+/CD8~+ ratio than the boys. The newborn group had the highest percentages of CD3~+ T cells and CD3~+CD4~+ T cells and the highest CD4~+/CD8~+ ratio(P<0.05). The percentage of CD3~+CD4~+ T cells and the CD4~+/CD8~+ ratio gradually decreased with age and the preschool group had the lowest values(P<0.05). The newborn group had the lowest percentages of CD3~-CD19~+ B cells and CD3~-CD16~+CD56~+ NK cells(P<0.05). The percentage of CD3~-CD16~+CD56~+ NK cells gradually increased with age and the preschool group had the highest percentage(P<0.05). The percentage of CD3~-CD19~+ B cells reached the peak in the toddler period and then decreased with age(P<0.05). The preschool group had the highest percentage of CD3~+CD8~+ T cells(P<0.05). The variation trend of distribution of lymphocyte subsets in boys from different age groups was consistent with that in children from different age groups. For girls, the newborn group had the highest percentage of CD3~+CD4~+ T cells and CD4~+/CD8~+ ratio(P<0.05). Conclusions The distribution of peripheral blood lymphocyte subsets in healthy children is significantly different across ages and sexes. Therefore, the reference values should be established according to age and sex.
引文
[1]中国医师协会儿科医师分会风湿免疫专业委员会,中国医师协会儿科医师分会过敏专业委员会,中华医学会儿科分会免疫学组.流式细胞术分析外周血淋巴细胞亚群在儿科的临床应用共识[J].中华检验医学杂志,2016,39(5):344-349.
[2]朱立华,王建中.中国人血液淋巴细胞免疫表型参考值调查[J].中华医学检验杂志,1998(4):223-226.
[3]Kone B,Maiga M,Baya B,et al.Establishing reference ranges of hematological parameters from malian healthy adults[J].JBlood Lymph,2017,7(1):154.
[4]Chng WJ,Tan GB,Kuperan P.Establishment of adult peripheral blood lymphocyte subset reference range for an Asian population by single-platform flow cytometry:influence of age,sex,and race and comparison with other published studies[J].Clin Diagn Lab Immunol,2004,11(1):168-173.
[5]Castilho JL,Shepherd BE,Koethe J,et al.CD4/CD8 ratio,age,and risk of serious noncommunicable diseases in HIV-infected adults on antiretroviral therapy[J].AIDS,2016,30(6):899-908.
[6]赵宏,焦顺昌,张国庆,等.不同年龄、性别的健康成年人21项淋巴细胞亚群分析[J].标记免疫分析和临床,2011,18(2):99-102.
[7]Shearer WT,Rosenblatt HM,Gelman RS,et al.Lymphocyte subsets in healthy children from birth through 18 years of age:The pediatric AIDS clinical trials Group P1009 study[J].JAllergy Clin Immunol,2003,112(5):973-980.
[8]Ding Y,Zhou L,Xia Y,et al.Reference values for peripheral blood lymphocyte subsets of healthy children in China[J].JAllergy Clin Immunol,2018,142(3):970-973.
[9]郭志宏,姚亚萍,李西婷,等.浙江地区健康青少年和成人外周血T淋巴细胞免疫表型调查及正常参考值范围的建立[J].中国预防医学杂志,2008,9(1):32-35.
[10]林珊,高虹,李晶,等.福州地区健康儿童外周血淋巴细胞亚群及主要活化相关指标正常参考范围的建立[J].实验与检验医学,2016,34(3):298-303.
[11]李蓓,陆军,李志敏.80例健康儿童淋巴细胞亚群参考范围的调查分析[J].广州医药,2010,41(2):22-25.
[12]Kam KM,Leung WL,Wong KH,et al.Maturational changes in peripheral lymphocytes subsets pertinent to monitoring human immuno-deficiency virus-infected Chinses pediatric patients[J].Clin Diagn Lab Immunol,2001,8(5):926-931.
[13]肖婧,申丹,刘永革,等.以流式细胞术建立中国汉族健康儿童外周血淋巴细胞亚群相对计数的正常参考值[J].中国循证儿科杂志,2010,5(4):245-250.
[14]Tollerud DJ,Ildstad ST,Brown LM,et al.T-cell subsets in healthy teenagers:transition to the adult phenotype[J].Clin Immunol Immunopathol,1990,56(1):88-96.
[15]Tsegaye A,Wolday D,Otto S,et al.Immunophenotyping of blood lymphocytes at birth,during childhood,and during adulthood in HIV-1-uninfected Ethiopians[J].Clin Immunol,2003,109(3):338-446.
[2]朱立华,王建中.中国人血液淋巴细胞免疫表型参考值调查[J].中华医学检验杂志,1998(4):223-226.
[3]Kone B,Maiga M,Baya B,et al.Establishing reference ranges of hematological parameters from malian healthy adults[J].JBlood Lymph,2017,7(1):154.
[4]Chng WJ,Tan GB,Kuperan P.Establishment of adult peripheral blood lymphocyte subset reference range for an Asian population by single-platform flow cytometry:influence of age,sex,and race and comparison with other published studies[J].Clin Diagn Lab Immunol,2004,11(1):168-173.
[5]Castilho JL,Shepherd BE,Koethe J,et al.CD4/CD8 ratio,age,and risk of serious noncommunicable diseases in HIV-infected adults on antiretroviral therapy[J].AIDS,2016,30(6):899-908.
[6]赵宏,焦顺昌,张国庆,等.不同年龄、性别的健康成年人21项淋巴细胞亚群分析[J].标记免疫分析和临床,2011,18(2):99-102.
[7]Shearer WT,Rosenblatt HM,Gelman RS,et al.Lymphocyte subsets in healthy children from birth through 18 years of age:The pediatric AIDS clinical trials Group P1009 study[J].JAllergy Clin Immunol,2003,112(5):973-980.
[8]Ding Y,Zhou L,Xia Y,et al.Reference values for peripheral blood lymphocyte subsets of healthy children in China[J].JAllergy Clin Immunol,2018,142(3):970-973.
[9]郭志宏,姚亚萍,李西婷,等.浙江地区健康青少年和成人外周血T淋巴细胞免疫表型调查及正常参考值范围的建立[J].中国预防医学杂志,2008,9(1):32-35.
[10]林珊,高虹,李晶,等.福州地区健康儿童外周血淋巴细胞亚群及主要活化相关指标正常参考范围的建立[J].实验与检验医学,2016,34(3):298-303.
[11]李蓓,陆军,李志敏.80例健康儿童淋巴细胞亚群参考范围的调查分析[J].广州医药,2010,41(2):22-25.
[12]Kam KM,Leung WL,Wong KH,et al.Maturational changes in peripheral lymphocytes subsets pertinent to monitoring human immuno-deficiency virus-infected Chinses pediatric patients[J].Clin Diagn Lab Immunol,2001,8(5):926-931.
[13]肖婧,申丹,刘永革,等.以流式细胞术建立中国汉族健康儿童外周血淋巴细胞亚群相对计数的正常参考值[J].中国循证儿科杂志,2010,5(4):245-250.
[14]Tollerud DJ,Ildstad ST,Brown LM,et al.T-cell subsets in healthy teenagers:transition to the adult phenotype[J].Clin Immunol Immunopathol,1990,56(1):88-96.
[15]Tsegaye A,Wolday D,Otto S,et al.Immunophenotyping of blood lymphocytes at birth,during childhood,and during adulthood in HIV-1-uninfected Ethiopians[J].Clin Immunol,2003,109(3):338-446.