手足口病患儿血清TNF-αIL-6及sICAM-1的变化及意义

Clinical significance of serum levels of tumor necrosis factor-α interleukin-6 and soluble intercellular adhesion molecule-1 in children with hand-foot-and-mouth disease

目的探讨手足口病（HFMD）患儿血清肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）及可溶性细胞间黏附分子1（s ICAM-1）的变化及意义。方法 2015年1-3月江苏省南通市第一人民医院采用ELISA测定45例重症（重症组）、42例普通HFMD患儿（普通组）急性期和恢复期TNF-α、IL-6、s ICAM-1的水平,与25例正常儿童（对照组）进行对比分析。结果普通组和重症组患儿急性期TNF-α、IL-6、s ICAM-1的水平较对照组显著升高（P〈0.05）,重症组较普通组显著升高（P〈0.05）,急性期比恢复期有显著增高（P〈0.05）;重症组恢复期水平仍高于对照组,差异有统计学意义（P〈0.05）,普通组恢复期水平高于对照组,但差异无统计学意义（P〉0.05）。结论 TNF-α、IL-6、s ICAM-1参与了HFMD的病理生理过程,其水平与疾病的发生、发展和病情严重程度有关,动态观察水平变化可有助于判断其严重程度及预后。

Objective To evaluate the concentrations of peripheral blood tumor necrosis factor-α（TNF-α）,interleukin-6（IL-6） and soluble intercellular adhesion molecule-1（s ICAM-1） in the serum of hand-foot-and-mouth disease（HFMD） children and their effects on the pathogenesis of HFMD. Methods The levels of TNF-α,IL-6,s ICAM-1 in serum were determined before and after treatment with the method of ELISA,in 45 children who were admitted with severe HFMD and 42 children with mild HFMDand 25 children as normal controls. Results The levels of TNF-α,IL-6,s ICAM-1 in serum before treatment were significantly higher than those in controls（P〈0. 05）,TNF-α,IL-6,s ICAM-1 levels in severe HFMD group were higher than those in the mild HFMD group（P〈0. 05）; after treatment,the TNF-α,IL-6,s ICAM-1 levels in severe HFMD were higher than those of control group（P〈0. 05）,and the difference of TNF-α,IL-6,s ICAM-1 between mild HFMD and control group had no statistical significance（P〉0. 05）. Conclusion TNF-α,IL-6,s ICAM-1 may contribute to the pathogenesis of HFMD,the increase is closely correlated with the severity of the injury,and TNF-α,IL-6,s ICAM-1 may serve as markers in severity and prognosis of HFMD.