EV71感染手足口病血清细胞因子联合免疫球蛋白检测的临床意义

The Clinical Significance of Detecting Immunoglobulins and Cytokines in Children with Hand-foot-mouth Disease Caused by EV71

目的:探讨血清细胞因子联合免疫球蛋白检测对手足口病病情判断及预后评估的意义,为手足口病病情判断及预后评估提供依据。方法:选择2015年4月到2016年4月在武汉市金银潭医院住院治疗的手足口病患儿40例,分为轻症组24例和重症组16例。入组病例手足口病毒学检测均为单纯EV71阳性。同期以10例健康体检儿童为对照组。采用酶联免疫吸附法测定血清细胞因子HMGB1、IFN-γ和IL-4水平,采用免疫比浊法测定血清免疫球蛋白IgM、IgG、IgA水平。结果:手足口病组HMGB1、IFN-γ和IL-4水平均较对照组明显升高(P<0.001),且重症组升高更明显(P<0.01)。无论是轻症还是重症手足口病患儿血清IgG、IgM均高于对照组,IgA低于对照组。其中重症组IgG、IgM高于轻症组,IgA低于轻症组(P<0.001)。结论:EV71感染可改变机体的免疫功能,并且与手足口病的病情严重程度密切相关。

Objective:To investigate the significance of serum cytokines combined with immunoglobulin test,so as to provide basis for the diagnosis and prognosis of hand foot and mouth disease(HFMD)) HFMD.Methods:40 cases with HFMD were selected as the research sujects who were hospitalized Wuhan Jinyintan Hospital during April 2015-April 2016.All the patients were divided into mild case group(24 cases)and severe case group(26 cases)according to the diagnostic criteria of HFMA.All the patients wereEV71 postive .Meanwhile,10 healthy children were chosen as the control group.The level of HMGB1,IFN-γand IL-4 were measured by ELISA,and immunoglobulin IgM,IgGand IgA were measured by Immune Turbidimetry.Results:The levels of HMGB1,IFN-γand IL-4 of in HFMD group were significantly higher than the control group those in control group( P < 0.05),especially in severe group( P < 0.01).Serum IgG and IgM in mild or severe HFMD were higher than those in control group,and IgA was lower than those in control group. IgG and IgM in severe group were higher than those in mild group,IgA was lower than those in mild group.Conclusions:EV71 infection can change the immune function of the body and their levels are closely related to the severity of HFMD.