外周血T淋巴细胞亚群在EV71型手足口病患者病情判断中的价值

Value of peripheral blood T lymphocyte subsets in condition judgment of HFMD

目的探讨肠道病毒71（EV71）型手足口病（HFMD）患儿外周血淋巴细胞亚群与病情严重程度的相关性。方法选取2011年5月～2014年5月在深圳市龙岗中心医院儿科住院的EV71型HFMD患儿150例,根据《手足口病诊治指南（2013年版）》分为普通组100例、重症组50例,两组患儿年龄均为2～5岁;选择同年龄段的90例健康儿童作为对照组。采用流式细胞术检测EV71型HFMD患儿病程第3天及对照组儿童外周血T细胞亚群CD3＋、CD4＋、CD8＋百分数。重症组患儿按手足口病诊治指南规范治疗5 d后再次检测上述相关指标,并与治疗前进行比较。结果重症组外周血T细胞亚群CD3＋、CD4＋、CD8＋百分数较对照组及普通组显著降低,差异均有高度统计学意义（P〈0.01）,重症组CD4＋/CD8＋比值低于普通组及对照组,差异均有高度统计学意义（P〈0.01）;重症组患儿经过规范治疗后外周血T淋巴细胞亚群百分数上升,但与治疗前比较差异无统计学意义（P〉0.05）。结论EV71型HFMD患儿存在细胞免疫功能紊乱,外周血T细胞亚群水平变化可能与患儿病情严重程度存在一定程度的相关性。

Objective To investigate the relationship between the peripheral blood lymphocyte subsets and the severity of the disease in children with enterovirus 71-induced hand, foot and mouth disease （HFMD）. Methods one hundred and fifty cases of enterovirus 71-induced HFMD children from May 2011 to May 2014 in Longgang Center Hospital of Shenzhen City were selected, they were divided into common group （100 cases）, severe group （50 cases） according to Hand Foot Mouth Disease Diagnosis and Treatment Guidelines （2013 Edition）, age of children in two groups was 2-5 years old, 90 healthy children with the same age were selected as the control group. Flow cytometry was used to detect the T cell subsets CD8^＋, CD4^＋ and CD3^＋ in the peripheral blood of children with enterovirus 71-induced HFMD in the third days and control group. The related indexes were detected again after 5 days of treatment in the severe group, they were compared with before treatment. Results The CD8^＋, CD4^＋ and CD3^＋ of T cells in severe group were significantly lower than the common group and the control group, the differences were statistically significant （P 〈 0.01）; the ratio of CD4^＋/CD8^＋ in severe group was lower than the common group and control group, the difference was statistically signifi- cant （P 〈 0.01）; the peripheral blood T lymphocyte subsets of the severe group after standard treatment was significantly decreased, but there was no obvious difference compared with before treatment （P 〉 0.05）. Conclusion There are some cellular immune function disorders in children with enterovirus 71-induced HFMD. The changes of T cell subsets in peripheral blood are correlated with the severity of the disease.