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目的探讨不同病情的手足口病患儿(HFMD)主要细胞因子及免疫球蛋白IgM、IgG、IgA的表达水平及其变化的临床意义。方法收集HFMD患儿50例,根据病情分为重症组12例,轻症组38例,另外选取同龄健康者15例为对照组。应用液相芯片分析平台检测IL-4、IL-6、IL-10、IL-17A、TNF-α、IGF-β水平;实时荧光定量PCR检测上述细胞因子mRNA表达水平;免疫比浊法检测免疫球蛋白IgM、IgG、IgA的水平。结果重症组患儿血清各细胞因子水平显著高于轻症组及对照组(P<0.05);重症组患儿外周血单个核细胞表达的各细胞因子mRNA水平显著高于轻症组(P<0.05);重症组及轻症组血清免疫球蛋白IgM、IgG、IgA的水平较对照组明显下降(P<0.05);重症组与轻症组间免疫球蛋白水平无明显差异(P>0.05)。结论HFMD患儿存在细胞因子水平的改变,体液免疫功能低下,这些变化可能参与HFMD病情的发展。
Objective To investigate the clinical significance of the expression of major cytokines and immunoglobulin IgM, IgG and IgA in HFMD children with different disease conditions. Methods Fifty children with HFMD were enrolled. According to their condition, they were divided into 12 cases in severe group and 38 cases in mild group. Fifteen cases of same age group were selected as control group. The levels of IL-4, IL-6, IL-10, IL-17A, TNF-α and IGF-β were detected by liquid chromatography platform. The mRNA expression of cytokines was detected by real-time fluorescence quantitative PCR Globulin IgM, IgG, IgA levels. Results Serum levels of cytokines in severe group were significantly higher than those in mild group and control group (P <0.05). The levels of cytokines in peripheral blood mononuclear cells in severe group were significantly higher than those in mild group (P < 0.05). The levels of serum immunoglobulin IgM, IgG and IgA in severe group and mild group were significantly lower than those in control group (P <0.05), while there was no significant difference in immunoglobulin levels between severe group and mild group (P> 0.05) . Conclusions There is a change in cytokine levels and humoral immunity in HFMD children, which may be involved in the development of HFMD.