淋巴细胞亚群及炎症因子检测在肠道病毒71型感染重症手足口病诊断中的价值

The diagnosis value of lymphocyte subsets and inflammatory factors detection in severe hand-foot-mouth disease with enterovirus 71infection

目的探讨肠道病毒71型(EV71)感染手足口病(HFMD)患儿淋巴细胞亚群及炎症因子水平与病情严重程度的相关性,分析其对该病的诊断价值。方法选取2018年1月至2020年1月嘉兴市第一医院收治的100例手足口病患儿为研究对象,根据《手足口病诊疗指南(2018版)》中的标准将患儿分为重症组(40例)和普通组(60例),采用流式细胞术检测淋巴细胞亚群水平,采用ELISA法检测IL-6、IL-8和IL-10水平,对比两组患儿各指标水平。结果重症组患儿外周血T淋巴细胞(CD3^(+)细胞、CD3^(+)CD8^(+)细胞、CD3^(+)CD4^(+)细胞)水平低于普通组(均P<0.05),而B淋巴细胞(CD3-CD19^(+))、自然杀伤细胞(CD3-CD56/16^(+))水平差异无统计学意义(均P>0.05)。重症组患儿IL-6、IL-8、IL-10水平均高于普通组(均P<0.05)。结论EV71感染HFMD患儿存在体液及细胞免疫功能紊乱和炎症因子大量释放的情况,动态监测T淋巴细胞及IL-6、IL-8、IL-10等炎症因子水平变化对判断HFMD病情严重程度具有一定的临床价值。

Objective To study the correlation between the lymphocyte subsets and inflammatory factors and the severity of illness in hand-foot-mouth disease(HFMD)in children with enterovirus 71(EV71)infection,and analyze the diagnosis value.Methods A total of 100 children with HFMD who admitted to our hospital from January 2018 to January 2020 were divided into severe HFMD group(40 cases)or moderate HFMD group(60 cases)according to the criteria in the Guide for Diagnosis of HFMD(2018).Flow cytometry was used to detect the lymphocyte subsets.ELISA method was used to detect the levels of IL-6,IL-8 and IL-10,and the differences between the two groups were observed.Results The levels of T lymphocytes(CD3^(+)cells,CD3^(+)CD8^(+)cells,CD3^(+)CD4^(+)cells)in peripheral blood in the severe HFMD group were significantly lower than those in the moderate HFMD group(P<0.05).There were no statistically significant differences in B lymphocytes(CD3-CD19^(+)cells)and natural killer cells(CD3-CD56/16^(+)cells)between groups(all P>0.05).The levels of IL-6,IL-8 and IL-10 in the severe HFMD group were significantly higher than those in moderate HFMD group(all P<0.05).Conclusion Children with HFMD and EV71 infection have cellular immune disorders,and increased released inflammatory factors.Dynamic monitoring of changes in the levels of T lymphocytes and inflammatory factors such as IL-6,IL-8 and IL-10 has certain clinical value in assessing the severity of HFMD.