手足口病患儿细胞因子水平及免疫球蛋白的变化及其临床意义

Changes and significances of cytokines and immunoglobulin in serum in children with hand-foot-mouth disease

目的探讨不同病情的手足口病患儿(HFMD)主要细胞因子及免疫球蛋白IgM、IgG、IgA的表达水平及其变化的临床意义。方法收集HFMD患儿50例,根据病情分为重症组12例,轻症组38例,另外选取同龄健康者15例为对照组。应用液相芯片分析平台检测IL-4、IL-6、IL-10、IL-17A、TNF-α、IGF-β水平;实时荧光定量PCR检测上述细胞因子mRNA表达水平;免疫比浊法检测免疫球蛋白IgM、IgG、IgA的水平。结果重症组患儿血清各细胞因子水平显著高于轻症组及对照组(P<0.05);重症组患儿外周血单个核细胞表达的各细胞因子mRNA水平显著高于轻症组(P<0.05);重症组及轻症组血清免疫球蛋白IgM、IgG、IgA的水平较对照组明显下降(P<0.05);重症组与轻症组间免疫球蛋白水平无明显差异(P>0.05)。结论HFMD患儿存在细胞因子水平的改变,体液免疫功能低下,这些变化可能参与HFMD病情的发展。

Objective To explore the levels and clinical significance of cytokines and immunoglobulin in children with hand-foot-mouth disease（HFMD）.Methods 50 children with HFMD were enrolled,and divided into severe case group（12 cases） or mild case group（38 cases） according to the clinical condition of the disease,with 15 healthy children as the control group.The levels of IL-4,IL-6,IL-10,IL-17 A,TNF-α and TGF-β were detected by using luminex liquichip;the expression levels of mRNA in peripheral blood mononuclear cells were determined with Real-time PCR;the levels of IgA,IgG and IgM were detected with immune turbidimetry.Results The serum levels of cytokines mentioned above in the severe case group were higher than those in mild case group or control group（P〈0.05）;the expression levels of cytokine mRNA in peripheral blood mononuclear cells in the severe case group were significantly higher than those in mild case group（P〈0.05）.Compared with control group,the levels of IgM,IgG and IgA were higher in both severe and mild case group（P〈0.05）,but there were no significant differences between severe case group and mild case group（P〉0.05）.Conclusion The levels of some cytokines changed and humoral immune function lowered in children with HFMD,which may play important roles in the pathogenesis of HFMD.