重症71型肠道病毒感染手足口病患儿的免疫指标分析

刘静; 刘晓莺

文章摘要

重症71型肠道病毒感染手足口病患儿的免疫指标分析

Changes of immune indices in enterovirus 71-infected children with severe HFMD

投稿时间：2016-12-19

DOI：10.3969/j.issn.1000-0399.2017.08.012

中文关键词: 手足口病 71型肠道病毒细胞免疫体液免疫

英文关键词: Hand,foot and mouth disease Enterovirus 71 Cellular immunity Humoral immunity

基金项目:

作者	单位
刘静	719000 陕西省榆林市第一医院检验科
刘晓莺	719000 陕西省榆林市第一医院检验科

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中文摘要:

目的探讨71型肠道病毒感染手足口病患儿的免疫指标变化情况，分析其临床意义。方法选取2013年5月至2016年5月我院收治的71型肠道病毒感染所致的手足口病患儿170例为研究对象，按照疾病程度的不同将其分为轻症组80例以及重症组90例，另取同期于我院进行体检的同龄健康儿童70例作为对照组。对三组儿童细胞免疫（免疫表型及炎性因子）以及体液免疫（免疫球蛋白及补体）各指标检测结果进行回顾性分析与比较。结果重症组患儿CD₃⁺ T细胞数量为（59.41±6.08）%、CD₃⁺CD₄⁺T细胞数量为（17.44±4.20）%，CD₃⁺CD₈⁺T细胞数量为（26.25±4.58）%；均低于轻症组[分别为（66.33±7.52）%、（20.01±3.86）%、（39.66±4.93%]及对照组[（73.58±7.94）%、（23.75±3.11）%、（51.32±5.07）%]差异有统计学意义（P<0.05），重症组CD₁₉⁺ B细胞数量为（19.24±8.05）%，高于轻症组（14.68±6.71）%及对照组（12.03±5.22）%，差异均有统计学意义（P<0.05）。三组儿童CD₄⁺/CD₈⁺以及CD₁₆⁺CD₅₆⁺ NK细胞数量相比差异无统计学意义（P>0.05）。重症组患儿IL-6、IL-10以及TNF-α表达水平均高于轻症组及对照组，差异均有统计学意义（P<0.05）。重症组患儿免疫球蛋白及补体表达水平高于轻症组及对照组，差异有统计学意义（P<0.05）。结论重症71型肠道病毒感染手足口病患儿存在明显的细胞免疫及体液免疫功能紊乱，临床应根据患儿具体情况适当开展免疫治疗。

英文摘要:

Objective To explore the changes of immune indices in those children with severe hand, foot and mouth disease (HFMD) infected by enterovirus 71 (EV71), and to analyze their clinical significance. Methods 170 cases of EV71-infected children with HFMD, ever treated in our hospital from May 2013 to May 2016, were selected and divided into the moderate group of 80 cases and the severe group of 90 cases, according to the severity of illness. Other 70 healthy children from their peers underwent physical examinations in our hospital were enrolled simultaneously as the control group. Then the results of immune indices of cellular immunity (groups of immune-phenotype and levels of inflammatory factors) and humoral immunity (levels of immunoglobulins and complements) among the 3 groups were compared and analyzed. Results The percent of CD₃⁺ T cells, CD₃⁺CD₄⁺ T cells and CD₃⁺CD₈⁺ T cells of children in the severe group were (59.41±6.08)%, (17.44±4.20)%, and (26.25±4.58)%, respectively, which were significantly lower than those results of children in the moderate group[(66.33±7.52)%, (20.01±3.86)%, (39.66±4.93)%] and the control group[(73.58±7.94)%, (23.75±3.11)%, (51.32±5.07)%] (all P<0.05). But the percent of CD₁₉⁺ B cells of children in the severe group[(19.24±8.05)%] was significantly higher than those results of children in the moderate group[(14.68±6.71)%] and the control group[(12.03±5.22)%], with statistically significant differences (P<0.05). There had no significant difference in the percent of CD₄⁺/CD₈⁺ NK cells and CD₁₆⁺CD₅₆⁺ NK cells of children among the 3 groups (P>0.05). The expression levels of IL-6, IL-10 and TNF-α of children in the severe group were, respectively, which were significantly higher than those in the moderate group and the control group(all P<0.05), and the levels of immunoglobulins and complements in the severe group were also significantly higher than those in the other 2 groups, with statistically significant differences (P<0.05). Conclusion There is obvious dysfunction of cellular immunity and humoral immunity in the EV71-infected children with severe HFMD, and immunotherapy should be administered at the right moment according to the specific conditions of HFMD children.

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