鼠神经生长因子对危重型小儿手足口病患者体液免疫和细胞因子的影响

Effects of mouse nerve growth factors on humoral immunity and cytokines in children with severe hand foot and mouth diseases

目的探讨鼠神经生长因子(m NGF)对危重型小儿手足口病(HFMD)患者体液免疫和细胞因子的影响。方法选取2014年6月~2015年10月深圳市龙华新区人民医院收治的危重型HFMD患儿88例,按照随机数字表法分为观察组和对照组,每组各44例。对照组给予双黄连常规治疗,观察组在对照组的基础上注射m NGF进行治疗。比较治疗前后两组患儿免疫球蛋白M(Ig M)、Ig G、Ig A,及CD4^+、CD8^+、CD4^+/CD8^+水平;比较两组治疗效果及不良反应发生情况。结果治疗前两组患儿Ig M、Ig G、Ig A水平比较,差异均无统计学意义(P>0.05);治疗后两组患儿血清Ig M、Ig G、Ig A水平显著升高,且观察组明显高于对照组,差异均有高度统计学意义(P<0.05)。治疗前两组患儿CD4+、CD8+、CD4+/CD8+比较,差异均无统计学意义(P>0.05);治疗后两组患儿CD4^+、CD8^+、CD4^+/CD8+均有所升高,且与本组治疗前比较,差异均有高度统计学意义(P<0.01);治疗后观察组各项指标均明显高于对照组,差异均有高度统计学意义(P<0.01)。观察组总有效率(93.18%)明显高于对照组(70.45%),差异有高度统计学意义(P<0.01)。观察组2例患儿出现注射部位轻微疼痛,停药后症状自行消失。两组患儿治疗期间肝肾等脏器功能检查,均未发现异常。结论 m NGF治疗危重型HFMD患儿效果显著,能明显改善患儿体液免疫功能和细胞因子的水平,且不良反应少,值得临床进一步推广。

Objective To explore the effects of mouse nerve growth factors （mNGF） on humoral immunity and cytokines in children with severe hand foot and mouth diseases （HFMD）. Methods From June 2014 to October 2015, 88 children with severe HFMD treated in Longhua New District People＇s Hospital of Shenzhen were selected and divided into observation group and control group according to the random digital table method, with 44 cases in each group. The control group were given conventional symptomatic treatment by Shuang Huang Lian Oral Solution, and the observation group were given the injection of mNGF based on the control group. Levels of IgM, IgG, IgA, and CD4＋, CD8＋, CD4＋/ CD8＋ before and after treatment were compared; treatment effects and adverse reactions of the two groups were compared. Results There were no significant differences in IgM, IgG and IgA before treatment between the two groups （P 〉 0.05）, which were significantly increased after treatment, IgM, IgG and IgA of the observation group after treatment were significantly higher than those of the control group, the differences were statistically significant （P 〈 0.01）. There were no significant differences in CD4＋, CD8＋ and CD4＋/CD8＋ before treatment between the two groups （P 〉 0.05）, which were significantly increased after treatment （P 〈 0.01）; compared with before treatment, the differences were statistically significant （P 〈 0.01）; CD4＋, CD8＋ and CD4＋/CD8＋ of the observation group after treatment were significantly higher than those of the control group, the differences were statistically significant （P 〈 0.01）. The total effective rate of the observation group （93.18%） was significantly higher than that of the control group （70.45%）, the difference was statistically significant （P 〈 0.01）. There were 2 cases with slight pain in the injection site in the observation group, and disappearance of symptoms after drug withdrawal. There was no function abnormal, such as liver, kidney and other organ in the two groups during the treatment. Conclusion The effect of mNGF in the treatment of children with severe HFMD is remarkable, which can obviously improve the humoral immune function and the levels of cytokines, and with less adverse reactions, it is worthy of further promotion in clinical.