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目的 :探讨γ干扰素诱导蛋白10(interferon-γinducible protein-10,IP-10)在手足口病(hand-foot-mouth disease,HFMD)儿童血浆中的表达水平及临床意义。方法 :选取HFMD患儿74例,根据是否伴有神经系统症状将患儿分为重症组和普通感染组;另选取30例体检儿童作为健康对照组。采用流式液相多重蛋白定量检测技术检测血浆中IP-10的表达量,同时检测分析淋巴细胞亚群比例、免疫球蛋白和血常规相关指标。比较各指标在健康对照组、HFMD普通感染组及重症组中的差异;分析IP-10与皮疹出现天数及淋巴细胞各亚群比例之间的相关性。结果 :HFMD普通感染组及重症组患儿白细胞计数均增高,但和健康对照组相比无统计学差异。HFMD普通感染组及重症组患儿IP-10蛋白表达均显著增加(P<0.001),重症组IP-10蛋白表达略低于普通感染组,差异无统计学意义(P>0.05)。HFMD普通感染组及重症组患儿T细胞比例显著降低(P<0.001),其中CD4+T淋巴细胞与CD8+T淋巴细胞亦显著降低(P<0.05)。相反,B淋巴细胞比例显著增加(P<0.001)。HFMD普通感染组、重症组与健康对照组相比,Ig A降低,Ig G增加,但无统计学差异(P>0.05)。HFMD普通感染组患儿IP-10蛋白表达量与皮疹天数呈负相关(P<0.05),而重症组虽IP-10蛋白表达量与皮疹天数呈负相关,但无统计学意义。HFMD重症组IP-10蛋白表达量与T淋巴细胞比例呈正相关,其中与CD4+T淋巴细胞的正相关有统计学意义(P<0.01)。结论 :HFMD患儿T淋巴细胞比例降低,B淋巴细胞比例增加,IP-10蛋白表达显著增加,与皮疹天数呈负相关。
Objective: To investigate the expression of interferon-γ-induced protein-10 (10-IP) in the plasma of hand-foot-mouth disease (HFMD) children and its clinical significance. Methods: Totally 74 HFMD children were divided into severe group and common infection group according to whether they had neurological symptoms or not. 30 healthy children were selected as healthy control group. Flow cytometry was used to detect the expression of IP-10 in plasma. The ratio of lymphocyte subsets, immunoglobulins and blood-related indexes were detected and analyzed. The differences of each index in healthy control group, HFMD common infection group and severe group were compared. The correlation between IP-10 and the occurrence of rash and the proportion of lymphocyte subsets were analyzed. Results: The white blood cell counts of HFMD infection group and severe disease group were all increased, but there was no significant difference compared with healthy control group. The expression of IP-10 protein in HFMD infection group and severe disease group were significantly increased (P <0.001), and the expression of IP-10 protein in severe disease group was slightly lower than that in normal infection group. There was no significant difference (P> 0.05). The proportion of T cells in HFMD infection group and severe disease group was significantly lower than that in HFMD group (P <0.001). CD4 + T lymphocytes and CD8 + T lymphocytes were also significantly decreased (P <0.05). In contrast, the proportion of B lymphocytes was significantly increased (P <0.001). HFMD common infection group, severe group compared with healthy controls, Ig A decreased, Ig G increased, but no significant difference (P> 0.05). The expression of IP-10 protein was negatively correlated with the days of rash in HFMD common infection group (P <0.05), while the expression of IP-10 protein in severe group was negatively correlated with the days of rash but not statistically significant. The expression of IP-10 protein in HFMD severe group was positively correlated with the proportion of T lymphocytes, and there was a significant positive correlation with CD4 + T lymphocytes (P <0.01). Conclusion: The proportion of T lymphocytes in children with HFMD is decreased, the proportion of B lymphocytes is increased, the expression of IP-10 protein is significantly increased, and negatively correlated with the number of rash days.