手足口病患儿免疫学指标变化的临床意义

Clinical Significance of Immunological Changes in Children with Hand-Foot-Mouth Disease

目的探讨手足口病(hand,foot and mouth disease,HFMD)患儿细胞免疫和体液免疫指标改变的临床意义。方法80例HFMD患儿根据卫健委手足口病预防控制指南分为轻型组38例和重症组42例,选取同年龄段正常体检儿童40例为对照组,检测外周静脉血T淋巴细胞亚群、血清免疫球蛋白、血清补体及炎症细胞因子。结果HFMD轻型组和重症组患儿外周血T淋巴细胞亚群(CD3^(+)、CD4^(+)和CD8^(+)细胞)检测值均低于正常儿童,差异有统计学意义(P<0.01),重症组低于轻型组(P<0.05)。HFMD轻型组和重症组患儿血清免疫球蛋白(IgG、IgA和IgM)、血清炎症细胞因子(IL-1、IL-6和TNF-α)水平高于正常儿童且随病情加重升高(P<0.01),INF及C3和C4含量低于正常儿童且随病情加重下降(P<0.01)。结论HFMD患儿细胞免疫和体液免疫指标较正常儿童均改变且随病情加重变化幅度增加,可为临床判断病情严重程度及采取干预措施提供一定参考依据。

Objective To explore the clinical significance of the changes of cellular immunity and humoral immunity in children with hand-foot-mouth disease(HFMD).Methods A total of 80 children with HFMD were divided into a mild group(n=38)and a severe group(n=42)according to the guidelines for the prevention and control of HFMD of the Ministry of Health.And normal children of the same age group were chosen as controls(n=40).The levels of T lymphocyte subsets,serum immunoglobulin,serum complement and inflammatory cytokine in peripheral venous blood of patients in each group were detected and compared.Results The detection values of peripheral blood T lymphocyte subsets(CD3^(+),CD4^(+)and CD8^(+)cells)in the mild group and severe group of children with HFMD were significantly lower than those in control group(P<0.01).The values in the severe group were significantly lower than those in the mild group(P<0.05).The levels of serum immunoglobulins(IgG,IgA and IgM)and serum inflammatory cytokines(IL-1,IL-6 and TNF-α)in children with HFMD in mild and severe groups were higher than those in control group.With the aggravation of the disease,the levels of IgG,IgA and IgM increased,the contents of serum INF,C3 and C4 decreased,and the levels of IL-1,IL-6 and TNF-αincreased,and the differences among different groups were statistically significant(P<0.01).Conclusion Cellular immune and humoral immune indicators in children with HFMD change with the aggravation of the disease,which may provide a certain reference for doctors to judge the severity of the disease and take interventions.