肠道病毒71感染病毒载量与细胞因子和免疫球蛋白水平的相关性

Correlation between EVTI viral load and the levels of the cytokines and immunoglobulin

目的检测手足口病患儿肠道病毒71型（EV71）病毒载量与白介素6（IL-6）、白介素10（IL-10）、SIOOB、免疫球蛋白A（IgA）、G（IgG）水平，探讨EV71病毒载量与细胞免疫、体液免疫以及病情轻重的关系。方法收集本院儿科确诊的手足口病例385例，根据临床症状和体征将其分为轻度组（237例）和重症组（148例）。患儿咽拭子采用实时荧光定量反转录PCR技术检测EV71病毒核酸；采用双抗体夹心法检测患儿血液和脑脊液中白介素6（IL-6）、白介素10（IL-10）及S100B水平；免疫比浊法检测血清IgA、IgG水平。结果EV71病毒载量在重症组与轻度组间差异无统计学意义（P〉0．05）；血清IL-6、IL-10和脑脊液S100B水平均与病情轻重呈高度相关性（P〈0．01），脑脊液IL-6、IL-10、WBC计数与病情轻重呈低度正相关性（P〈0．05），血清S100B与病情轻重呈中度正相关（P〈0．01）；IgA、IgG水平均与病情轻重呈中度负相关性（P〈0．05）。结论EV71病毒载量的高低与患儿免疫状态无关，也不能作为判断病情轻重的关键因素。

Objective To detect the EV71 viral load and the levels of the IL-6,1L-10,SIOOB in blood serum and CSF; lgA, IgG in blood serum with hand foot and mouth disease（HFMD） children infected with EV71 ;then to explore the correlation among EV71 viral load and cellular immunity, humoral immunity, the state of the disease with HFMD. Methods 385 HFMD children cases were enrolled in the study, including 237mild cases and 148 severe cases. Specimens of the childreng throat swabs were collected, and the nucleic acid testing was conducted by the fluorescent quantitative RT-PCR method. The levels of IL-6 ,IL- 10,S100B In blood serum and CSF were detected by ELISA and the levels of IgA, IgG in blood serum were detected by immune turbidity method. Results There was no significant difference of EV71 viral load between the severe and the mild group （P 〉 0.05）. The levels of IL-6, IL-10 in serum and levels of SIOOB in CSF were highly positive correlated with the severity of disease （P 〈 O. 01 ） ; the IL-6, IL-10 levels and WBC count in CSF were lowly positive correlated with the disease severity（ P 〈 0. 05 ） ; the levels of S100Bin serum were moderate positive correlated with the disease （P 〈 0. 01 ） ; the IgA and IgG levels in serum were moderate negative correlated with the disease severity （ P 〈 0. 01 ） ; there was no significant difference of EV71 viral load in throat swab of HFMD children between the age, IL-6, S100B, IL-10, IgA and IgG levels （P 〉 0. 05）. Conclusions The level of EV71 viral load might be not related to immune status of HFMD children and the level of EV71 viral load might not be used as a key factor to determine the severity of HFMD disease.