论文部分内容阅读
目的研究EV71型手足口病患儿淋巴细胞亚群失衡与手足口病重症化之间的相关性。方法收集2013年4月至2015年10月间本院收治的EV71型手足口病患儿共496例,根据病情分为普通型组(220例)、重症组(191例)以及危重症组(85例);选择同期本院门诊100例健康体检儿童为对照组。采取流式细胞仪检测各组患儿外周血T淋巴细胞(CD3~+)、Th细胞(CD3~+CD4~+)、Tc细胞(CD3~+CD8~+)、NK细胞(CD16~+56~+)和B淋巴细胞(CD19~+)数量及其所占淋巴细胞的百分比,并应用ELISA法测定各组细胞因子IL-6、IL-10、TNF-α和IFN-γ的血清浓度。结果淋巴细胞亚群CD3~+、CD3~+CD4~+、CD3~+CD8~+的百分比在对照组、普通型组、重症组和危重症组中逐渐降低;而CD19~+则呈相反趋势;CD16~+CD56~+百分比在对照组、重症组、普通型组、危重症组中依次降低。各组淋巴细胞亚群差异具有统计学意义(F=243.38、206.52、41.85、4.27、314.54,P均<0.05),而组间比较中,除重症组和危重症组患儿CD3~+CD4~+、对照组和重症组以及普通型组和危重症组患儿CD16~+CD56~+差异无统计学意义外(P>0.05),其余各组差异具有统计学意义(P均<0.05)。细胞因子IL-6和IL-10在对照组、普通型组、重症组和危重症组中逐渐升高;TNF-α和IFN-γ在对照组、普通型组、重症组中逐渐升高,但在危重症组中却出现下降。各组细胞因子差异具有统计学意义(F=55.32、75.47、416.37、321.31,P均<0.05);而组间多重比较中,差异亦具有统计学意义(P均<0.05)。结论 EV71型手足口病患儿存在细胞免疫功能紊乱和炎症因子失调;淋巴细胞亚群失衡可能为手足口病重症化的重要因素之一。
Objective To investigate the correlation between imbalance of lymphocyte subsets and severity of hand-foot-mouth disease in children with EV71 hand-foot-mouth disease. Methods A total of 496 children with EV71 type HFMD were enrolled in our hospital from April 2013 to October 2015. The patients were divided into general type (220 cases), severe group (191 cases) and critically ill group 85 cases); choose the same period outpatient hospital 100 cases of healthy children as the control group. The levels of T lymphocytes (CD3 +), Th cells (CD3 + CD4 +), Tc cells (CD3 + CD8 +) and NK cells (CD16 + 56) were measured by flow cytometry ~ (+)) And B lymphocytes (CD19 ~ +), and the percentage of lymphocytes. Serum levels of IL-6, IL-10, TNF-α and IFN-γ were measured by ELISA. Results The percentages of CD3 ~ +, CD3 ~ + CD4 ~ +, CD3 ~ + CD8 ~ + in lymphocyte subsets gradually decreased in control group, common type group, severe group and critically ill group, while CD19 ~ + showed the opposite trend ; CD16 ~ + CD56 ~ + percentage in the control group, severe group, normal group, critically ill group in turn decreased. The differences of lymphocyte subsets in each group were statistically significant (F = 243.38, 206.52, 41.85, 4.27, 314.54, P <0.05) +, While there was no significant difference in CD16 ~ + CD56 ~ + between control group and severe group as well as normal group and critically ill group (P> 0.05). The differences between the other groups were statistically significant (all P <0.05). The levels of cytokines IL-6 and IL-10 gradually increased in control group, common type group, severe group and critically ill group. The levels of TNF-α and IFN-γ gradually increased in control group, common type group and severe group, However, there was a decline in critically ill patients. The difference of cytokines in each group was statistically significant (F = 55.32, 75.47, 416.37, 321.31, P <0.05). However, the differences among the groups were also statistically significant (all P <0.05). Conclusions Children with EV71 type HFMD have dysfunction of cellular immune function and inflammatory factors. The imbalance of lymphocyte subsets may be one of the important factors of severe HFMD.