手足口病患儿T淋巴细胞亚群与NK细胞和血清白介素、TNF-α变化的研究

Changes of T lymphocyte subsets,NK cells,serum interleukin and TNF alpha in children with hand,foot and mouth disease

目的探讨手足口病患儿机体T淋巴细胞亚群、NK细胞及血清白细胞介素-6(IL-6)、IL-10、IL-17、肿瘤坏死因子-α(TNF-α)变化,分析其在手足口病疾病发生及发展中可能所起的作用。方法选取2014年1月-2015年8月诊治的手足口病患儿100例为手足口病组,以1∶1比例随机选取同期门诊健康体检儿童100名为对照组,采用流式细胞仪检测外周T淋巴细胞亚群(CD3+、CD4+、CD8+)、NK细胞占淋巴细胞百分比,以酶联免疫吸附法测定血清IL-6、IL-10、IL-17、TNF-α,数据采用SPSS 17.0统计软件进行分析。结果 CD3+、CD4+、CD8+、NK细胞水平手足口病组为(43.23±6.18)(39.51±4.56)(30.44±5.01)(12.49±6.29)%、对照组为(53.29±5.72)(43.29±5.43)(25.11±4.72)(9.31±5.21)%,血清IL-6、IL-10、IL-17、TNF-α水平手足口病组为(31.73±15.45)(39.53±14.74)(33.23±12.34)(2.67±0.47)pg/ml,对照组为(18.32±5.80)(24.98±5.49)(25.11±4.72)(1.70±0.42)pg/ml,两组比较差异有统计学意义(P<0.05);手足口病组普通型CD3+、CD4+、CD8+、NK细胞水平为(46.54±5.13)(44.14±4.22)(26.14±5.42)%(10.04±5.15)%,重症型为(38.66±4.65)(33.11±5.40)(31.15±4.77)(15.88±5.75)%,血清IL-6、IL-10、IL-17、TNF-α水平普通型为(23.15±10.66)(30.42±10.55)(29.65±10.89)(2.33±0.43)pg/ml,重症型为(43.57±18.90)(52.12±16.61)(38.18±16.55)(3.13±0.49)pg/ml,比较差异有统计学意义(P<0.05)。结论手足口病患儿存在免疫功能紊乱,主要表现为T淋巴细胞亚群水平紊乱,血清IL-6、IL-10、IL-17、TNF-α升高。

OBJECTIVE To discuss changes of T lymphocyte subsets,NK cells,serum interleukin 6（IL-6）,interleukin 10（IL-10）,interleukin 17（IL-17）and tumor necrosis factor alpha（TNF-α）in children with hand,foot and mouth disease,so as to analyze their roles in the occurrence and development of hand,foot and mouth disease.METHODS The 100 cases of children with hand,foot and mouth disease（the HFMD group）from Jan.2014 to Aug.2015 were selected,and another 100 healthy children by clinical physical examination during the same period were randomly selected as the control group by 1∶1proportion.The flow cytometry instrument was used to detect peripheral T lymphocytes（CD3^＋）,T helper cells（CD4^＋）,inhibit T cell（CD8^＋）,NK cells,and the method of enzyme-linked immunosorbent was used for determination of serum IL-6,IL-10,IL-17,and TNF-α.Data were analyzed by statistical software SPSS 17.0.RESULTS CD3^＋,CD4^＋,CD8^＋,NK cells were（43.23±6.18）（39.51±4.56）（30.44±5.01）（12.49±6.29）%in the HFMD group,and were（53.29±5.72）（43.29±5.43）（25.11±4.72）（9.31±5.21）% in the control group.Serum IL-6,IL-10,IL-17 and TNF-αlevels were（31.73±15.45）（39.53±14.74）（33.23±12.34）（2.67±0.47）pg/ml in the HFMD group,and were（18.32±5.80）（24.98±5.49）（25.11±4.72）（1.70±0.42）pg/ml in the control group,with significant differences（P〈0.05）.The levels of CD3^＋,CD4^＋,CD8^＋,NK cells were（46.54±5.13）（44.14±4.22）（26.14±5.42）（10.04±5.15）% in the normal HFMD group,and were（38.66±4.65）（33.11±5.40）（31.15±4.77）（15.88±5.75）%in the severe HFMD group;the levels of serum IL-6,IL-10,IL-17 and TNF-αwere（23.15±10.66）（30.42±10.55）（29.65±10.89）（2.33±0.43）pg/ml in the normal HFMD group,and were（43.57±18.90）（52.12±16.61）（38.18±16.55）（3.13±0.49）pg/ml in the severe HFMD group,with significant differences（P〈0.05）.CONCLUSION HFMD in children with immune dysfunction is mainly manifested as disorder of T lymphocyte subgroup level and elevated serum levels of a variety of inflammatory cells,such as IL-6,IL-10,IL-17 and TNF-α.