重症手足口病患儿的营养状况评估及其与靶器官功能损伤、免疫应答的相关性研究

Nutritional status of children with severe hand-foot-mouth disease and its correlation with target organ damage and immune response

目的:评估重症手足口病患儿的营养状况,分析营养状况与靶器官功能损伤、免疫应答的相关关系。方法:112例重症手足口病患儿根据病情分为重症组38例、普通组74例,另取在本院接受疫苗接种的健康小儿作为对照组(n=58)。对比三组研究对象的营养状况、肝功能及心功能、免疫应答水平差异,进一步分析重症手足口病患儿的营养状况与靶器官损伤、免疫应答的相关关系。结果:重症组患儿的外周血营养指标前白蛋白(Pre-ALB)、转铁蛋白(TF)、血红蛋白(HB)含量低于普通组及对照组;血清肝功能指标谷丙转氨酶(ALT)、谷草转氨酶(AST)、直接胆红素(DBIL)、总胆红素(TBIL)含量高于普通组及对照组;心功能指标每搏输出量(SV)、心排出量(CO)、左心室舒张末期容积(LVEDV)、舒张期早期峰值速度/晚期峰值速度(Ve/Va)水平均低于普通组及对照组;免疫应答指标CD19+、CD56+B淋巴细胞含量低于普通组及对照组,IgG、IgM、IgA含量高于普通组及对照组,差异均具有统计学意义(P<0.05)。重症手足口病患儿的Pre-ALB、TF、HB含量与肝功能、心功能、细胞免疫及体液免疫状态均存在直接相关关系。结论:重症手足口病患儿营养状况不佳,是导致患儿靶器官损伤、免疫应答异常的重要原因之一。

Objective：To assess the nutritional status of children with severe hand-foot-mouth disease and analyze the correlation between nutritional status and target organ damage as well as immune response.Methods：A total of 112 children with severe hand-foot-mouth disease were divided into severe group（n=38）and common group（n=74）according to the condition,and health children who received vaccination in our hospital were selected as control group（n=58）.The differences in nutritional status,liver function and cardiac function as well as immune response levels were compared among three groups,and the correlation between the nutritional status of children with severe hand-foot-mouth disease and target organ damage as well as immune response was further analyzed.Results：Nutritive indexes Pre-ALB,TF and HB content in peripheral blood ofsevere group were lower than those of common group and control group;liver function indexes ALT,AST,DBIL and TBIL content in serum were higher than those of common group and control group;cardiac function indexes SV,CO,LVEDV and Ve/Va levels were lower than those of common group and control group;immune response indexes CD19＋and CD56＋B lymphocyte content were lower than those of common group and control group while IgG,IgM and IgA content were higher than those of common group and control group.Pre-ALB,TF and HB content in children with severe hand-foot-mouth disease were directly correlated with liver function,cardiac function as well as cellular immunity and humoral immunity state.Conclusion：Children with severe hand-foot-mouth disease are with poor nutritional status,which is one of the important causes of target organ damage and abnormal immune response in children.