手足口病中医证型与血清炎性细胞因子、T细胞亚群、NK细胞相关性分析

Analysis on Correlation Between TCM Syndromes of Hand, Foot and Mouth Disease and Serum Proinflammatory Cytokines, T Cell Subgroup and NK Cells

目的研究手足口病(HFMD)肺脾湿热证、湿热郁蒸证、毒热动风证与白细胞介素-6(IL-6)、降钙素原(PCT)、C反应蛋白(CRP)及CD3^+、CD4^+、CD8^+T细胞、NK细胞之间的相关性。方法随机选取90例HFMD患者,肺脾湿热证、湿热郁蒸证、毒热动风证各30例,检测血清炎性细胞因子(IL-6、PCT、CRP)、T细胞亚群(CD3^+、CD4^+、CD8^+)、NK细胞等指标,分析上述指标在各证型间的分布情况。结果毒热动风证IL-6、PCT、CRP水平明显高于肺脾湿热证、湿热郁蒸证,差异均有统计学意义(P<0.01);CD3^+、CD4^+、CD8^+、NK细胞绝对值毒热动风证与肺脾湿热证组、湿热郁蒸证组间比较差异均有统计学意义(P<0.01);CD3^+细胞百分比毒热动风证组与肺脾湿热证组间比较差异均有统计学意义(P<0.01),与湿热郁蒸证组间差异有统计学意义(P<0.05);CD4^+细胞百分比毒热动风证组与肺脾湿热证组间比较差异有统计学意义(P<0.05),与湿热郁蒸证组间比较差异有统计学意义(P<0.01);CD8^+、NK细胞百分比毒热动风证组与肺脾湿热证组、湿热郁蒸证组间比较差异均有统计学意义(P<0.01)。结论 HFMD肺脾湿热证、湿热郁蒸证、毒热动风证在相关炎性细胞因子、促炎标志物及T细胞亚群等方面不仅与发病有关,并且与病情轻重及预后密切相关,能够较为有效地评估病情及判断预后。

Objective To study the correlation between hand, foot and mouth disease (HFMD) in lung-spleen damp-heat syndrome, syndrome of stagnation and steaming due to damp-heat, and syndrome of stirring wind due to toxic-heat with IL-6, PCT, CRP, CD3+, CD4+, CD8+ and NK cells.Methods Ninety patients with HFMD were randomly selected, dividing into lung-spleen damp-heat syndrome, syndrome of stagnation and steaming due to damp-heat, and syndrome of stirring wind due to toxic-heat, 30 cases for each syndrome. IL-6, PCT, CRP, CD3+, CD4+, CD8+ and NK cells were detected, and the distribution of above indicators in the three syndromes were analyzed.Results Levels of IL-6, PCT and CRP in syndrome of stirring wind due to toxic-heat were significantly higher than those in lung-spleen damp-heat syndrome and syndrome of stagnation and steaming due to damp-heat, with statistical significance (P<0.01); There was statistical significance in absolute value counting of CD3+, CD4+, CD8+ and NK cells among the three syndromes (P<0.01); There was statistical significance in the percentage of CD3+ cells in syndrome of stirring wind due to toxic-heat and lung-spleen damp-heat syndrome (P<0.01) and syndrome of stagnation and steaming due to damp-heat (P<0.05); There was statistical significance in the percentage of CD4+ cells syndrome of stirring wind due to toxic-heat and lung-spleen damp-heat syndrome (P<0.05) and syndrome of stagnation and steaming due to damp-heat (P<0.01); There was statistical significance in the percentages of CD8+ and NK cells in the three syndromes (P<0.01).Conclusion Proinflammatory cytokines, proinflammatory markers, and T cell sub-group related to HFMD in lung-spleen damp-heat syndrome, syndrome of stagnation and steaming due to damp-heat, syndrome of stirring wind due to toxic-heat are not only correlative with morbidity, but also with the severity of diseases and prognosis, which can relatively effectively evaluate the state of diseases and judge prognosis.