手足口病患儿治疗前后血清白介素-10、12和肿瘤坏死因子-α水平的变化

Changes of serum interleukin-10 and 12 and tumor necrosis factor-α of children with hand-foot-mouth disease before and after medical treatment

目的 探讨手足口病患儿治疗前后血清白介素（IL）-10、12和肿瘤坏死因子（TNF）-α水平变化.方法 选择2012年1～12月浙江省三门人民医院收治的,手足口病患儿40例（病例组）,予以抗病毒、退热、营养支持及维持水电解质酸碱平衡等常规治疗,连用3d.观察患者治疗前和治疗3d后血清IL-10、12和TNF-α水平的变化.另选择同期体检中心的30例正常健康儿童作对照组.比较两组IL-10、12和TNF-α水平的差异.结果 病例组患者治疗前血清IL-10、12和TNF-α水平[（48.23±12.41）μg/L、（28.22±8.27） pg/mL、（2.91±0.47） pg/mL]明显高于对照组[（31.52±9.12）μg/L、（10.02±2.89） pg/mL、（1.04±0.27） pg/mL]（t=2.89、3.21、3.37,P＜ 0.01）.治疗3d后,患者血清IL-10、12和TNF-α水平[（39.15±8.62） μg/L、（17.72±3.14） pg/mL、（1.72±0.39） pg/mL]较治疗前[（48.23±12.41）μg/L、（28.22±8.27） pg/mL、（2.91±0.47） pg/mL]明显下降（t=2.39、2.89、3.02,P＜0.05或P＜0.01）.结论 手足口病患儿存在血清IL-10、12和TNF-α水平的异常升高.IL-10、12和TNF-α水平的变化可作为手足口病患儿疗效随访的指标.

Objective To discuss the changes of serum interleukin-10 and 12 （IL-10 and 12） and tumor necrosis fac tor-α （TNF-α） of children with hand-foot-mouth disease before and after medical treatment.Methods 40 cases of children with hand-foot-mouth disease from January to December 2012 collected by Sanmen People＇s Hospita were selected as case group,and given the routine medical treatment like antivirus,defervescence,nutritional support,maintenance of water and electrolyte acid-base balance and etc for 3 days.The changes of serum IL-10 and 12 and TNF-αlevels of patients before and after 3 days＇medical treatment,and clinical curative observation was carried on as well.30 cases of healthy children,who were taking the physical examination in medical examination center （MEC） in the same period,were selected as control group.Differences in two groups of the levels of IL-10,12,and TNF-α were compared Results The serum IL-10 and 12 and TNF-α levels of patients in case group [（48.23±12.41） μg/L,（28：22±8.27） pg/ mL,（2.91±0.47） pg/mL] were much higher than those in control group before medical treatment [（31.52±9.12） μg/L,（10.02±2.89） pg/mL,（1.04±0.27） pg/mL] （t =2.89,3.21、3.37,P 〈 0.01）.After 3 days＇medical treatment,the serum IL10 and 12 and TNF-α levels of patients [（39.15±8.62） μg/L,（17.72±3.14） pg/mL,（1.72±0.39） pg/mL] were declined obviously than before [（48.23±12.41） μg/L,（28.22±8.27） pg/mL,（2.91±0.47） pg/mL] （t =2.39,2.89,3.02,P 〈 0.05 or P 〈0.01）.Conclusion The serum IL-10 and 12 and TNF-α levels of patients of children with hand-foot-mouth disease have abnormal elevation.The changes of serum IL-10 and 12 and TNF-α levels can be the index of clinical follow-up.