Study On Cellular Immune Status Of Children With Chronic Rhinosinusitis

Objective:This study investigates the peripheral blood cellular immune status of children with chronic rhinosinusitis(CRS)and the correlation between the two,to provide a basis for the development of more reasonable clinical treatment,thereby improving the cure rate of children with CRS and shortening the course of treatment.Background and Methods:Chronic rhinosinusitis(CRS)has gradually become one of the common and frequently occurring diseases of pediatrics.At present,the study on the pathogenesis of CRS in children is not yet fully understood.Most of the current domestic studies on this are focuses on the distribution of bacteria in the nasal cavity and cytokines and eosinophils of nasal polyps,and there is rarely research on the cellular immune status in peripheral blood of children with CRS.In this study,we enrolled 71 children with CRS(experimental group)and 59 healthy children(control group)from outpatients of respiratory department since March 2016 to March 2017.The detected of CD4~+ T cells(Th),CD8~+ T cells(Ts),CD19~+B cells,CD3~+T cells,NK cells and CD4~+/CD8~+were implemented in both group.SPSS17.0 statistical software was used to analyze the data,use rate to reprent enumeration data and compare two groups by chi-square test,All measurement data was asked to use homogeneity of variance and normal distribution test before analyzing,and expressed as mean±standard deviation.The two groups were compared by t test.Logistic multivariate regression analysis was used to determine the influencing factors of disease.P <0.05 was defined as a statistically significant difference.Results:There were 71 cases of children with chronic rhinosinusitis(CRS),including 46 males and 25 females with an average age of 4.13 ± 1.95 years.Among the 59 cases of normal healthy subjects,including 40 males and 19 females and the average age ofthis group is 5.02 ± 3.60 years old.Use t test to compare the age of the two groups,the results is t=1.799,P= 0.074,the difference is not statistically significant.The chi-square test was used to compare the gender difference between two groups,?~2=0.130,P=0.718,the difference is not statistically significant.The difference of CD4~+ T cells(Th)and CD3~+ T cells between CRS group and healthy children group was proved is not statistically significant.NK cells in CRS group is lower than that healthy children group(t=7.301,P= 0.000,the difference is statistically significant),CD8~+ T cells in CRS group were lower than those in healthy group(t=2.992,P=0.000,the difference is statistically significant),The CD19~+B cells in CRS group were higher than healthy children group(t=-7.828,P= 0.000,the difference is statistically significant),The ratio of CD4~+/CD8~+ in CRS group is higher than healthy children group(t=-3.265,P= 0.000,the difference is statistically significant).The Logistic regression analysis is used to analyze the above-mentioned statistically significant indicators.The result of CD8~+ T cells were P= 0.419,OR = 0.883,95% CI:0.653-1.194,the ratio of CD4~+/CD8~+: P= 0.712,OR = 0.607,95% CI: 0.043-8.650,the result of CD8~+T cells and the ratio of CD4~+/CD8~+ means that there aren't independent risk factors of CRS.The results of NK cell is: P= 0.008,OR = 0.799,95% CI: 0.678-0.943,CD19~+B cells results is: P= 0.009,OR = 1.224,95% CI:1.052-1.423,indicating that NK cells may be a protective factor for CRS in children,whereas CD19~+B cells is willing to be a risk factor.Conclusion:1.Compared to control group,the CD4~+T cells and CD3~+T cells in peripheral blood of children with CRS were don't have significant difference.2.Compared with healthy children,NK cells,CD8~+ T cells and CD19~+B cells and the ratio of CD4~+/CD8~+were increased in CRS children's peripheral blood.3.According to Logistic regression analysis,CD8~+ T cells and CD4~+/CD8~+ ratio were not independent risk factors of CRS,NK cell reduction and CD19~+ B cell may cause children with CRS.