危重型和重型手足口病患儿免疫功能的变化

Study on the Change of Immunity Function in Children with Critical and Severe Hand-foot-mouth Disease

【目的】研究重型和危重型手足口病患儿免疫功能的变化。【方法】以本院154例危重型和96例重型手足口病患儿及96例健康儿童为研究对象；采用散射比浊法检测其血清免疫球蛋白和补体，采用流式细胞仪检测法检测患儿外周血T、B细胞亚群和NK细胞。【结果】重型、危重型手足口病患儿的B细胞、IgG、IgM、C3和C4水平明显升高，差异有统计学意义（P〈0．05），而NK细胞、IgA和IgE水平无明显变化（P〉0．05），重型、危重型手足口病患儿的总T细胞、CD4＋细胞和cD4＋／cD8＋水平下降，差异有统计学意义（P〈0．05）；重型手足口病患儿的CD8＋细胞水平明显升高，差异有统计学意义（P〈0．05），而危重型手足口病患儿的CD8＋细胞水平无变化（P〉0．05）。【结论】重型和危重型手足口病患儿体内的NK细胞无变化，体液免疫功能和C3、C4水平升高，其主要是导致患儿抗感染的细胞免疫应答无法有效诱导，从而使机体无法有效地清除病毒。

[Objective]To explore the change of immunologic function in children with critical and severe hand-foot- mouth disease（HFMD）. [Methods] Totally 154 children with critical HFMD, 96 children with severe HFMD and 96 healthy children in our hospital were enrolled in this study. Serum immunoglobulin and complements were measured by u- sing nephelometry. Flow cytometry was used to detect T, B cell subsets and NK cells in peripheral blood. [Results]The levels of B cells, IgG, IgM, C3 and CA in children with critical and severe HFMD increased obviously, and there was sig- nificant difference（ P %0.05）, but the levels of NK cells, IgA and IgE had no obvious change（ P〉0. 05）. The total T cells, CEN＋ cells and CI）4＋/CD8＋ cells in children with critical and severe HFMD decreased, and there was significant difference（ P 〈0.05）. The level of CD8＋ cells in children with severe HFMD obviously increased, and there was signifi- cant difference （ P〈0. 05 ）. The level of CD8＋ cells in children with critical HFMD had no change （ P〈0. 05 ）. [Conclusion]The NK cells in children with critical and severe HFMD has no change, but the function of humoral immuni- ty and the levels of C3 and C4 increase, which results in that cellular immunologic response can not be effectively induced so that the body can not effectively remove the virus.