不同年龄段儿童手足口病免疫细胞变化特点的研究

Study on the immunocyte variation feature of children with hand-foot-and-mouth disease in different age groups

目的 分析不同年龄段儿童手足口病免疫细胞变化的特点,以期为儿童手足口病的预防诊治提供指导。方法 2015年1月-2018年1月收集1 090例不同年龄段手足口病(HMFD)患儿EDTA抗凝外周血,经破红、洗涤处理后分别加入CD3、CD4、CD8、CD19及CD16/CD56 5种荧光单抗对细胞进行标记,流式细胞仪对CD3+、CD4+、CD8+、CD19+及CD16+/CD56+五种免疫细胞含量进行分析。将患儿分为0~6个月、6个月<~5岁、5<~12岁3组,使用SPSS 19.0软件对3组患儿5种细胞含量构成比和升降幅度分别进行比较。结果 6个月<~5岁组患儿占总例数的89.1%,为HFMD高发组;该年龄段患儿CD3+(χ~2=9.824,P=0.007)、CD4+(χ~2=16.367,P<0.001)及NK(χ~2=8.666,P=0.013)细胞含量降低的比例, CD19+细胞(χ~2=13.867,P=0.001)含量增高的比例与其他年龄组患儿比较,差异均有统计学意义;另外,该年龄段患儿CD3+细胞(F=3.907,P=0.020)含量降低的幅度,CD19+细胞(F=9.952,P<0.001)含量升高的幅度较其他年龄组患儿比较,差异有统计学意义。结论 6个月<~5岁是HFMD的高发年龄段,该年龄段患儿免疫细胞的变化更为明显。细胞免疫功能指标的下降伴随CD19+细胞含量增高提示患儿病情急变,临床宜加强该年龄段患儿的免疫功能监控,调节免疫平衡,及早预防,从而改善患儿预后。

Objective To disclose the immunocytes variation feature of children with hand-foot-and-mouth disease(HFMD)in different age groups,in order to provide guidance for the prevention and treatment of HFMD.Methods Totally 1 090 HFMD children were enrolled in this study from January 2015 to January 2018,and their EDTA anticoagulation peripheral blood samples were collected.Fluorescence labeling monoclonal antibodies against CD3,CD4,CD8,CD19 and CD16/CD56 were separately used to mark WBCs after erythrocytolysis and purification.Flow cytometry was employed to analyze the immunocyte content.Children were divided into three groups,including 0~6 months,6 months<-5 years old and 5<-12 years old.The constituent ratio and variations of content of CD3,CD4,CD8,CD19 and CD16/CD56 among different age groups were analyzed and compared by SPSS 19.0.Results HFMD was prevalent in children aged 6 months to 5 years(89.1%).There were significant differences on the constituent ratio of the decrease of CD3+(χ~2=9.824,P=0.007),CD4+(χ~2=16.367,P<0.001),NK(χ~2=8.666,P=0.013)and constituent ratio of the increase of CD19+(χ~2=13.867,P=0.001)cells between children aged 6 months to 5 years and other groups.Besides,the decrease level of CD3+cells(F=3.907,P=0.020)and the increase level of CD19+cells(F=9.952,P<0.001)were significantly different between children aged 6 months to 5 years and other groups.Conclusions HFMD is prevalent in children aged 6 months to 5 years,and the immunocyte variation is more obvious in this age group.Deficiency of cellular immunity accompanied with increase of CD19+cells indicates the acute transformation of the disease.So more attention should be paid to immunologic monitoring and balance regulation,thereby improving prophylaxis and prognosis of these patients.