儿童抽动障碍与病原微生物感染及其免疫的相关性

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目的探讨儿童抽动障碍(TD)与EB病毒(EBV)、人巨细胞病毒(HCMV)、肺炎支原体(MP)感染的相关性。方法选择TD患儿49例为病例组。健康对照组为本院同期体检的健康儿童47例。检测二组外周血EBV DNA水平、咽拭子MP DNA水平及尿HCMV DNA水平,并检测血T淋巴细胞亚群及IgA、IgG、IgM水平。结果病例组EBV、MP及HCMV的DNA检出率分别为22.49%、14.29%及6.12%;健康对照组分别为2.13%、2.13%及0,病例组显著高于健康对照组(Pa<0.015)。病例组CD4+T淋巴细胞、CD4+/CD8+淋巴细胞比值分别为(34.71±4.62)%和0.96±0.22,较健康对照组[(40.02±2.53)%、1.31±0.07]显著降低(Pa<0.05);CD8+[(36.28±3.95)%]较健康对照组[(30.65±6.51)%]显著升高(P<0.01)。而CD3+二组比较差异无统计学意义(P>0.05)。病例组IgG[(9.43±2.95)g·L-1]显著低于健康对照组[(16.23±3.13)g·L-1],差异有统计学意义(P<0.01)。结论 EBV、HCMV、MP等感染引起的免疫紊乱可能是导致儿童TD发生的因素之一。 Objective To investigate the relationship between tic disorder (TD) and Epstein-Barr virus (EBV), human cytomegalovirus (HCMV) and Mycoplasma pneumoniae (MP) infection in children. Methods 49 children with TD were selected as case group. The healthy control group was 47 healthy children in the same period of our hospital. The levels of EBV DNA in peripheral blood, MP DNA in pharyngeal swabs and HCMV DNA in urine were measured. Blood T lymphocyte subsets and IgA, IgG and IgM levels were also detected. Results The DNA detection rates of EBV, MP and HCMV were 22.49%, 14.29% and 6.12% in healthy controls and 2.13%, 2.13% and 0% in healthy controls respectively, significantly higher than those in healthy controls (Pa <0.015) . The ratio of CD4 + T lymphocytes and CD4 + / CD8 + lymphocytes in the case group was significantly lower than that in healthy control group (34.71 ± 4.62)% vs 0.96 ± 0.22 (40.02 ± 2.53% vs 1.31 ± 0.07%, P <0.05) ; CD8 + [(36.28 ± 3.95)%] was significantly higher than that in healthy controls [(30.65 ± 6.51)%] (P <0.01). There was no significant difference between the two groups (P> 0.05). The level of IgG (9.43 ± 2.95) g · L-1 in the case group was significantly lower than that in the healthy control group [(16.23 ± 3.13) g · L -1] (P <0.01). Conclusion The immune disorder caused by EBV, HCMV and MP infection may be one of the factors leading to TD in children.
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