手足口病并发脑炎患儿外周血淋巴细胞亚群变化的临床研究

Clinical research on peripheral blood lymphocyte subsets of hand, foot and mouth disease with complication of cerebritis in children

目的:研究手足口病(hand foot and mouth disease,HFMD)并发脑炎患儿外周血淋巴细胞亚群的变化,以探讨其免疫功能改变与疾病的关系。方法:收集2014年12月至2015年5月徐州市儿童医院收治的57例手足口病患儿的临床资料,根据病情严重程度分为手足口病并发脑炎组34例和手足口病未并发脑炎组23例,以20例同期进行腹股沟疝外科手术的儿童为对照组。应用流式细胞仪检测外周抗凝全血的淋巴细胞亚群:T淋巴细胞(CD3+CD19-)、辅助T细胞Th(CD3+CD4+)、抑制T细胞Ts(CD3+CD8+)、B淋巴细胞(CD3-CD19+)和NK细胞(CD3-CD56+/CD16+)的相对计数。结果:手足口病并发脑炎组患儿外周血T淋巴细胞(CD3+CD19-)、辅助T细胞Th(CD3+CD4+)、抑制T细胞Ts(CD3+CD8+)的百分率下降,明显低于手足口病未并发脑炎组及对照组(P<0.05);B淋巴细胞(CD3-CD19+)的百分率较其它2组明显增高(P<0.05);但手足口病未并发脑炎组与对照组之间辅助T细胞Th(CD3+CD4+)、抑制T细胞Ts(CD3+CD8+)、B淋巴细胞(CD3-CD19+)的差异无统计学意义(P>0.05)。手足口病并发脑炎组及手足口病未并发脑炎组NK细胞(CD3-CD56+/CD16+)百分率均高于对照组(P<0.05);但二者之间差异无显著性统计学意义(P>0.05)。结论:手足口病患儿特别是合并有脑炎的重症手足口病患儿存在明显的免疫功能低下及免疫调节紊乱。

Objective: To discuss the variation of peripheral blood lymphocyte subsets and the relationship between immunity and severity degree of hand, foot and mouth disease(HFMD) with complication of cerebritis in Children. Methods: Clinical data of 57 HFMD kids was collected from December 2014 to May 2015. 57 cases with HFMD were divided into two groups, HFMD with cerebritis group(34 cases with complication of cerebritis) and uncomplicated HFMD group(23 cases without complication). Meanwhile, 20 kids ready for inguinal hernia surgery as control. The percentage of lymphocyte subsets, including CD3+CD19- cell(T), CD3+CD4+ cell(Th), CD3+CD8+cell(Ts), CD3-CD19+ cell(B), CD3-CD56+/CD16+ cell(NK) was determined by flow cytometry(FCM). Results: Compared with uncomplicated HFMD group and control group, the HFMD with cerebritis group displayed significant decreases in their peripheral CD3+CD19- cell(T), CD3+CD4+ cell(h) and CD3+CD8+ cell(Ts) subsets(P<0.05), and had a substantial increase in their peripheral CD3-CD19+ cell(B) subset(P<0.05). But no significant difference between uncomplicated HFMD group and control group in the CD3+CD4+ cell(h), CD3+CD8+ cell(Ts) and CD3-CD19+ cell(B) subsets. Compared with control group, the HFMD with cerebritis group and uncomplicated HFMD group showed an obvious increase in percentage of CD3-CD56+/CD16+ cell(NK)(P<0.05), but no significant difference between the two groups(P>0.05). Conclusion: There are functional disorders in cellular immunity in HFMD children. The serious group with complication of cerebritis showed more serious disorder of immune function.