神经内分泌免疫学敏感性指标监测对小儿手足口病病情判断的价值

Clinicle study on changes of neuroendocrine immunology sensitive indicators in children with hand-footand-mouth disease

目的:对手足口病患儿神经内分泌、免疫学部分敏感指标进行监测,观察这些指标的变化对小儿手足口病病情判断的价值。方法:按照临床诊断和分型标准将手足口病患儿分为普通型、重型和危重型3组,同时以健康儿童作为对照组。采集病例组和对照组的静脉血,分别检测COR、β-EP、IL-13、IFN-γ及免疫球蛋白(IgG、IgA和IgM)含量和T细胞亚群、B细胞和NK细胞的相对含量。结果:手足口病3组与对照组比较,COR、β-EP、IL-13、IFN-γ和IgG、IgA、IgM的含量都显著增高,除普通型组的IgG、IgA以外,差异均有统计学意义(均P<0.01)。普通型组与对照组比较NK细胞、B细胞相对含量增高;其他两型组与对照组比较,T细胞亚群、NK细胞的相对含量显著降低,B细胞相对含量却显著增高,差异均有统计学意义(均P<0.01)。结论:EV71感染所致手足口病是由神经系统、免疫系统与内分泌系统改变共同影响的结果。早期监测敏感指标,发现危重病例,争取早期干预极为重要。

Objective To study the changes of Neuroendocrine immunology sensitive indicators in children with Hand-Foot-and-Mouth Disease （HFMD） and values of determining the patient＇s conditions. Methods The children with HFMD were divided into three groups, the common group, severe group and risk group according to the clinical diagnosis and classification standards, meanwhile, the healthy children were enrolled as control group. Peripheral blood samples were collected from the case groups and control group, concentrations of cortisol （COR）, β-endorphin （13-EP）, interleukin-13 （IL-13）, interferon-γ （IFN-γ）, immunoglobulin （IgG, IgA, and IgM）, and the relative contents of T cell subsets, B cells and NK cells were tested respectively. Results Compared with the control group, the levels of COR, β-EP, IL-13, IFN-γand IgG, IgA, IgM all significantly increased in the three groups of HFMD. All the differences were statistically significant （P 〈 0.01 ）, except the difference of IgG, and IgA between the ordinary type and the control group. Compared with the common group, the percentage of NK and B ceils dramatically increased, meanwhile, compared the other two types with the control group, the percentage of T cell subsets and NK cells significantly decreased, but B cells significantly increased, and there were all significant difference （P 〈 0.01 ）. Conclusions HFMD caused by EV71 infection is the result of the combined effect of changes in nervous system, immune system and endocrine system. It is extremely important to detect early the sensitive indicators in children with HFMD, such may help to find the risk cases and carry on early intervention for patients＇ recovery.