重症手足口病患儿血清免疫水平的变化情况及其临床意义研究

Changes of serum immune levels and their clinical significances in children with severe HFMD

目的探讨重症手足口病患儿血清免疫水平的变化情况,并分析其临床意义。方法选择手足口病患儿85例根据病情分为重症组45例和普通组40例;另选择健康体检儿童30名为对照组。检测三组血清免疫球蛋白水平以及血清细胞因子水平,分析重症手足口病患儿血清免疫水平的变化情况以及临床意义。结果重症组及普通组患儿血清免疫球蛋白M(Ig M)、血清免疫球蛋白G(Ig G)以及血清免疫球蛋白A(Ig A)水平均显著低于对照组(P<0.01);且重症组Ig M及Ig A水平也显著低于普通组(P<0.01)。重症组及普通组患儿血清白细胞介素-1β(IL-1β)、肿瘤坏死因子(TNF-α)、白细胞介素6(IL-6)、白细胞介素10(IL-10)水平均显著高于对照组(P<0.01);且重症组IL-1β、TNF-α、IL-6、IL-10水平也显著高于普通组(P<0.01)。结论重症手足口病患儿血清细胞因子水平显著升高,说明病毒进入机体后引起了强烈的炎症反应以及抗炎反应;患儿免疫球蛋白水平下降,说明重症手足口病机体免疫功能存在紊乱。检测重症手足口病患儿血清免疫水平对临床的诊断与治疗有重要的意义。

Objective To explore the changes of serum immune levels and their clinical significances in children with severe hand-foot-and-mouth disease（ HFMD）. Methods 85 cases with HFMD were selected,among whom 45 cases had severe HFMD and 40 cases had ordinary HFMD. Other 30 cases of healthy children were selected as the control group. Serum immunoglobulin levels and serum cytokine levels of the three groups were detected. The changes and clinical significances of serum immune levels in children with severe HFMD were analyzed. Results Ig M,Ig G and Ig A levels in both the severe group and the ordinary group were lower than those in the control group（ P〈0. 01）. Ig M and Ig A levels in the severe group were lower than those in the ordinary group（ P〈0. 01）. IL-1β,TNF-α,IL-6,IL-10 levels in the severe group were higher than those in the ordinary group（ P〈0. 01）,and all these indicators in both of the two groups were higher than those in the control group（ P〈0. 01）. Conclusion Children with severe HFMD serum cytokines are significantly increased,indicating that the virus in the body cause a strong inflammatory response and the inflammatory reaction; and that the decrease of immunoglobulin levels shows immune function disorders.