小儿手足口病中EV71与CoxA16两种肠道病毒同血清检验指标的相关性检测分析

Correlation Analysis of Serum EV71 and CoxA16 in Children with Hand-Foot-Mouth Disease

目的探究小儿手足口病中肠道病毒71型(EV71)与柯萨奇A组16型病毒(CoxA16)两种肠道病毒同血清检验指标检测的相关性。方法选取2014年3月至2017年3月本院就诊的确诊为手足口病的500例患儿作为研究对象。依据咽拭子样本检测结果将研究对象分为EV71组与CoxA16组,其中EV71感染者378例作为EV71组,CoxA16感染者122例作为CoxA16组。比较并分析EV71组与CoxA16组临床体征及实验室指标。结果 EV71组与CoxA16组手足口病患儿最高体温相较不具有统计学差异(P>0.05);EV71组手足口病患儿肢体抖动发生率高于CoxA16组,其差异具有统计学意义(P<0.05)。EV71组与CoxA16组患儿中性粒细胞百分比、白细胞、空腹血糖水平相较,两组差异不具有统计学意义(P>0.05)。EV71组与CoxA16组患儿IgA、IgG、IgM等体液免疫水平相较,两组差异不具有统计学意义(P>0.05)。EV71组与CoxA16组患儿T淋巴细胞、B淋巴细胞、CD3+CD8+T淋巴细胞及CD3+CD4+T淋巴细胞相较,两组差异不具有统计学意义(P>0.05);EV71组患儿自然杀伤细胞水平低于CoxA16组,其差异具有统计学意义(P<0.01)。结论小儿肢体抖动的临床特征及自然杀伤细胞水平可为EV71、CoxA16感染所致手足口病提供辅助鉴别依据,同时为判断小儿手足口病预后提供依据。

Objective To investigate the correlation of serum enterovirus 71(EV71)and coxsackievirus A16(CoxA16)in children with hand-foot-mouth disease.Methods A total of 500 children with confirmed hand-foot-mouth disease in our hospital from March 2014 to March 2017 were selected and divided into two groups according to the fecal sample test results,namely,EV71 group(n=378)and CoxA16 group(n=122).Then the clinical signs and laboratory parameters of two groups were compared and analyzed.Results The highest body temperature of the two groups had no difference(P>0.05).The incidence of limb jitter in EV71 group was higher than that in CoxA16 group(P<0.05).The percentages of neutrophils,white blood cells,and fasting blood glucose levels in the EV71 group and the CoxA16 group were not significantly different(P>0.05).The levels of humoral immunity such as IgA,IgG,IgM in EV71 group and CoxA16 group were either not statistically significant(P>0.05).The differences in T lymphocytes,B lymphocytes,CD3+CD8+T lymphocytes,and CD3+CD4+T lymphocytes between the EV71 group and the CoxA16 group were not statistically significant(P>0.05).Natural killer cells in the EV71 group were lower than those in the CoxA16 group(P<0.01).Conclusion The clinical features of pediatric limb shake and the level of natural killer cells can provide supplementary identification basis for hand-foot-mouth disease caused by EV71,CoxA16 infection,and also provide basis for the prognosis judgment.