血清免疫球蛋白、hs-CRP、IL-6和TNF-α水平与两种证型疱疹性咽峡炎患儿相关性的研究

Study on the correlation between serum immunoglobulin,hs-CRP,IL-6,TNF-αlevels and two types of herpes angina in children

目的探讨血清免疫球蛋白、高敏C-反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平与2种中医证型疱疹性咽峡炎患儿的相关性。方法前瞻性选择2018年1月到2020年1月在江苏省中西医结合医院诊治的疱疹性咽峡炎患儿80例,根据中医证型的不同分为风热乘脾型40例(A组)与脾胃积热型40例(B组)。收集2组患儿的临床症状,检测血清免疫球蛋白、hs-CRP、IL-6、TNF-α水平并进行相关性分析。结果A组患儿的流涎、头痛、惊厥的发生率为77.50%、22.50%、20.00%,显著高于B组(52.50%、5.00%、2.50%),差异有统计学意义(P<0.05),2组患儿咳嗽、呕吐、腹痛、腹泻等发生率比较(82.50%vs.80.00%、60.00%vs.52.50%、35.00%vs.32.50%、25.0%vs.27.50%、92.50%vs.95.00%),差异无统计学意义(P>0.05)。A组患儿的血清hs-CRP、IL-6、TNF-α水平为(30.33±2.39)、(51.94±6.89)、(40.10±2.19)mg/L,均显著高于B组[(22.49±3.32)、(41.87±7.24)、(29.38±5.11)mg/L],差异有统计学意义(P<0.05)。A组患儿的血清IgG、IgA、IgM值为(8.02±0.34)、(0.78±0.12)、(0.84±0.11)g/L,显著低于B组[(9.78±0.41)、(1.38±0.24)、(1.09±0.14)g/L],差异有统计学意义(P<0.05)。Pearson相关检验显示血清IgG、IgA、IgM、hs-CRP、IL-6、TNF-α与中医证型均存在相关性(r=-0.564、-0.613、-0.388、0.563、0.445、0.514,P<0.05)。结论血清免疫球蛋白、hs-CRP、IL-6、TNF-α在脾胃积热型与风热乘脾型疱疹性咽峡炎患儿中的表达水平存在差异,上述指标可能是影响该疾病患儿病情进展的重要因素。

Objective To explore and study the relevance of levels of serum immunoglobulin,high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)andtwo types of herpes angina in children.Methods From January 2018 to January 2020,80 cases of children with herpetic angina were selected to be diagnosed and treated in Jiangsu Hospital of Integrated Traditional Chinese and Western Medicine.Forty cases of wind-heat by spleen type(group A)and 40 cases of spleen and stomach accumulated heat type(group B)accorded to the different types of TCM syndromes.Collected the clinical symptoms of the two groups,detected the levels of serum immunoglobulin,hs-CRP,IL-6,and TNF-α,and were give correlation analysis.Results The incidence of salivation,headache,and convulsions in group A were 77.50%,22.50%,and 20.00%,which were significantly higher than those in group B(52.50%,5.00%,2.50%),and the differences were statistically significant(P<0.05).There were no statistically significant difference in the incidence of cough,vomiting,abdominal pain,and diarrhea compared between the two groups(82.50%vs.80.00%,60.00%vs.52.50%,35.00%vs.32.50%,25.00%vs.27.50%,92.50%vs.95.00%,P>0.05).The serum hs-CRP,IL-6,and TNF-αlevels of children in group A were(30.33±2.39),(51.94±6.89),(40.10±2.19)mg/L,which were significantly higher than those in group B[(22.49±3.32),(41.87±7.24),(29.38±5.11)mg/L],the differences were statistically significant(P<0.05).The serum IgG,IgA and IgM values of children in group A were(8.02±0.34),(0.78±0.12),(0.84±0.11)g/L,which were significantly lower than those in group B[(9.78±0.41),(1.38±0.24),(1.09±0.14)g/L],the differences were statistically significant(P<0.05).Pearson correlation test showed that serum IgG,IgA,IgM,hs-CRP,IL-6,TNF-αwere correlated with TCM syndrome types(r=-0.564,-0.613,-0.388,0.563,0.445,0.514;P<0.05).Conclusion The expression levels of serum immunoglobulin,hs-CRP,IL-6,and TNF-αare different in children with spleen and stomach accumulating heat type and wind-heating spleen herpetic angina,and the above indicators may be important factors affecting the progression of this disease in children.