肠道病毒71型手足口病病例血清中IL-10、IFN-γ、NSE、S100表达水平与病程进展的研究

Serum levels of IL-10,IFN-γ,NSE and S100 protein in the progression of enterovirus 71 HFMD

目的探讨肠道病毒71型(EV71)手足口病(HFMD)感染患儿血清白介素10(IL-10)、γ-干扰素(IFN-γ)、神经元烯醇化酶(NSE)、S100蛋白水平与病程进展的关系。方法选取平邑县人民医院2018年3月-2019年9月收治的EV71手足口病感染患儿189例为病例组,另选健康体检幼儿45名作为健康对照组。采用双抗夹心法检测IL-10、IFN-γ水平,采用电化学发光免疫法检测NSE、S100蛋白水平。并根据《肠道病毒71型感染重症病例临床救治专家共识》临床分期标准分为轻度组(n=88)、重度组(n=53)、危重组(n=48),比较3组治疗1、2、3 d血清IL-10、IFN-γ、NSE、S100蛋白动态水平变化。结果各组血清IL-10、IFN-γ、NSE、S100蛋白水平差异有统计学意义(P<0.05)。EV71感染HFMD患儿经入院治疗后各指标均逐步降低,其中轻度组治疗3 d血清IFN-γ、NSE、S100蛋白水平与健康对照组差异无统计学意义(P>0.05),但IL-10依旧显著高于健康对照组(P<0.05)。重度组、危重组治疗3d后血清IL-10、IFN-γ、NSE、S100蛋白水平显著高于轻度组(P<0.05)。结论动态监测EV71感染HFMD患儿血清IL-10、IFN-γ、NSE、S100蛋白水平变化,可实时掌握HFMD患儿机体炎症反应、神经元损伤病理生理变化情况,对重度、危重HFMD的早期发现、诊疗提供指导,改善预后归转。

Objective To investigate the changes of serum interleukin 10(IL-10),interferon-γ(IFN-γ)and neuron specific enolase(NSE),S100 protein expression levels in children with enterovirus 71(EV71)hand-foot-and-mouth disease(HFMD).Methods 189 children with EV71 hand,foot and mouth disease who were admitted to Pingyi County People’s Hospital from March 2018 to September 2019 were selected as the case group,and 45 children with healthy physical examination were selected as the healthy control group.Double antibody sandwich method was used to detect IL-10 and IFN-γ.Electrochemiluminescence immunoassay was used to detect NSE and S100 proteins.And according to the"Expert Consensus on Clinical Treatment of Enterovirus Type 71 Infection"clinical staging standards,patients were divided into mild group(n=88),severe group(n=53),and critical group(n=48).The dynamic changes of serum IL-10,IFN-γ,NSE,S100 protein levels during 1,2,and 3 days of treatment were analyzed.Results The serum levels of IL-10,IFN-γ,NSE,and S100 protein in mild group,severe group and critical group were significantly different(P<0.05).The indexes of EV71-infected children with HFMD were gradually reduced after being admitted to the hospital.Among them,serum IFN-γ,NSE,and S100 protein levels in the mild group after treatment were not significantly different from those in the healthy control group(P>0.05),but IL-10 level was still significantly higher than the healthy control group(P<0.05).Serum IL-10,IFN-γ,NSE,and S100 protein levels in the severe group and critical group were significantly higher than those in the mild group after 3 days of treatment(P<0.05).Conclusion Dynamic monitoring of serum IL-10,IFN-γand NSE,S100 protein expression levels in children with HFMD infected with EV71 could promptly grasp the inflammatory reaction and physiological changes of neuron injury in children with HFMD,provide guidance for early detection of severe and critical HFMD,and improve prognosis.