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[目的]总结手足口病(HFMD)患儿外周血T淋巴细胞、B淋巴细胞、NK细胞及NKT细胞免疫特征,探讨其在HFMD疾病发生发展中的机制及临床检测价值。[方法]应用流式细胞术检测152例HFMD患儿、45例健康对照组幼儿外周血中T淋巴细胞(CD3+细胞、CD3+CD4+细胞、CD3+CD8+细胞)、B淋巴细胞(CD3-CD19+细胞)、NK细胞(CD3-CD56+细胞)、NKT细胞(CD3+CD56+细胞)百分率,采用SPSS 13.0统计分析软件,分别对HFMD发病期与健康对照组、HFMD发病期与HFMD恢复期、HFMD重型组与HFMD普通组进行各组淋巴细胞亚群百分率间均数比较,两组间均数的比较方差齐时采用两个独立样本的t检验,方差不齐时用t’检验,P<0.05为差异有统计学意义。[结果]HFMD发病期CD3+细胞、CD3+CD4+细胞、CD3+CD8+细胞、NK细胞百分率及CD4+/CD8+比值低于健康对照组;NKT细胞、B细胞百分率HFMD发病期高于健康对照组,各组间均数的比较,差异均有统计学意义(P<0.05)。HFMD发病期CD3+细胞、CD3+CD4+细胞、CD3+CD8+细胞、NKT细胞百分率及CD4+/CD8+比值低于HFMD恢复期;B细胞、NK细胞百分率HFMD发病期高于HFMD恢复期,各组间均数的比较,差异均有统计学意义(P<0.05)。HFMD重型组CD3+细胞、CD3+CD4+细胞、CD3+CD8+细胞、NKT细胞百分率及CD4+/CD8+比值低于HFMD普通组;B细胞、NK细胞百分率HFMD重型组高于HFMD普通组,除NKT细胞外,其余各组间均数的比较,差异均有统计学意义(P<0.05)。[结论]HFMD患儿淋巴细胞亚群免疫功能紊乱。HFMD发病期淋巴细胞亚群中CD3+细胞、CD3+CD4+细胞百分率降低,B细胞百分率增高;HFMD恢复期NKT细胞百分率增高。淋巴细胞亚群免疫特征检测可作为HFMD患儿疾病转归分析指标。
[Objective] To summarize the immune features of T lymphocytes, B lymphocytes, NK cells and NKT cells in children with hand-foot-mouth disease (HFMD) and explore its mechanism and clinical value in the development of HFMD. [Methods] Flow cytometry was used to detect the expression of T lymphocytes (CD3 + cells, CD3 + CD4 + cells, CD3 + CD8 + cells) and B lymphocytes (CD3-CD19 + cells) in 152 children with HFMD and 45 healthy controls ), NK cells (CD3-CD56 + cells) and NKT cells (CD3 + CD56 + cells) were analyzed by SPSS 13.0 software. The correlation between HFMD incidence and duration of HFMD, HFMD recovery, HFMD common group, the mean percentage of lymphocyte subsets in each group was compared. The comparison of mean of mean between two groups was t-test with two independent samples at the same time. When variance was not good, the t-test was used. P <0.05 was the difference Statistical significance. [Results] The percentage of CD3 + cells, CD3 + CD4 + cells, CD3 + CD8 + cells, NK cells and CD4 + / CD8 + in HFMD were lower than those in healthy controls. The percentage of HFMD in NKT cells was higher than that in healthy controls Between the mean, the differences were statistically significant (P <0.05). The percentage of CD3 + cells, CD3 + CD4 + cells, CD3 + CD8 + cells, NKT cells and CD4 + / CD8 + in HFMD were lower than those in HFMD at the onset of HFMD. The incidence of HFMD in B cells and NK cells was higher than that in HFMD The differences were statistically significant (P <0.05). The percentage of CD3 + cells, CD3 + CD4 + cells, CD3 + CD8 + cells, NKT cells and CD4 + / CD8 + in HFMD severe group were lower than those in normal HFMD group. The percentage of B cells and NK cells in HFMD group was significantly higher than that in HFMD group The other groups between the mean comparison, the difference was statistically significant (P <0.05). [Conclusion] The immune function of lymphocyte subsets in children with HFMD is disorder. The percentages of CD3 + cells and CD3 + CD4 + cells in the lymphocyte subsets of HFMD were decreased and the percentage of B cells was increased. The percentage of NKT cells in HFMD recovery phase was increased. Detection of immune characteristics of lymphocyte subsets may be used as an index of disease outcome in children with HFMD.