手足口病患儿血液免疫学改变及其临床意义  

The expression and the clinical significance of blood and immunological changes of child patients with HFMD

作　　者：刘炜[1] 周崇臣[1] 包丰昌[1] 刘俊闪[1] 李彦格[1] 王国峰[1] 宋春兰[1] 

机构地区：[1]郑州市儿童医院,河南郑州450053

出　　处：《河南医学研究》2011年第4期406-409,共4页Henan Medical Research

基　　金：河南省医学科技攻关项目(201004018)

摘　　要：目的:探讨重症手足口病(HFMD)患儿外周血白细胞分类计数、淋巴细胞亚群及其绝对计数,细胞因子水平改变及其临床意义。方法:检测50例急性期重症HFMD患儿外周血白细胞分类计数,用流式细胞术检测淋巴细胞亚群及其绝对计数和急性期、恢复期IL-2 I、L-4I、L-6I、L-10、TNF-αI、NF-γ细胞因子水平,同时检测45例健康儿童作为对照组。结果:相比对照组,重症HFMD患儿急性期白细胞计数增高,淋巴细胞比值下降,淋巴细胞绝对计数升高,外周血CD3+T细胞、CD3+CD4+Th细胞、CD3+CD8+Ts细胞以及CD1+6 5+6NK细胞的百分率下降,CD1+9B细胞的百分率增高,Th、B、NK细胞绝对计数升高,差异均有统计学意义(P<0.05),而Ts细胞绝对计数、两组间Th/Ts细胞比值的变化差异无统计学意义;重症HFMD患儿急性期外周血IL-2 I、L-4I、L-6I、L-10、TNF-αI、NF-γ较对照组均升高(P<0.05),恢复期患儿IL-10较对照组升高(P<0.05),其余细胞因子水平与对照组比较无统计学意义(P>0.05)。结论:重症手足口病患儿淋巴细胞绝对计数和运用流式细胞术法检测其淋巴细胞各组分的绝对计数及IL-2I、L-4I、L-6I、L-10、TNF-αI、NF-γ细胞因子的血液免疫学指标可以准确地反映疾病急性期病理状态,并可作为重症手足口病临床分期的实验指标之一。Objective： To study peripheral blood leukocyte count,and absolute count of lymphocyte subsets,cytokine levels and clinical significance of severe HFMD（hand foot and mouth disease,HFMD）. Methods： Detecte 50 cases of acute severe HFMD children＇ peripheral blood leukocyte count,lymphocyte subsets and absolute counts and acute phase and recovery phase IL-2,IL-6,IL-10,TNF-α,INF-γ cytokines.45 cases of healthy children were selected as control group. Results： Compared to the control group,white blood cell count of acute severe HFMD children increased,lymphocyte ratio decreased,the absolute lymphocyte count increased,peripheral blood CD＋_3 T cells,CD＋_3 CD＋_4 Th cells,CD＋_3 CD＋_8 Ts cells and CD＋_16 ＋_56 NK cells was decline,CD＋_19 B cells was increased.Th,B,NK cell absolute count increased,the differences were statistically significant（P0.05）.While the Ts cell counts and Th/Ts cell ratio＇s between the two groups had no significant difference in change.Peripheral IL-2,IL-6,IL-10,TNF-α,INF-γ of acute severe HFMD children were increased differently than the control group,and IL-10 of the children in recovery phase was higher than the control group（P0.05）.The detection of cytokines were decreased in comparing with the control group（P0.05）. Conclusion：Absolute lymphocyte count of severe child patients with HFMD,using flow cytometry to detect the components of the absolute lymphocyte count and IL-2,IL-4,IL-6,IL-10,TNF-α,INF-γ cytokines can more accurately reflect the acute stage pathological conditions.The levels of cytokines can be used as one of the indicators of the clinical stage of severe HFMD.

关 键 词：手足口病 淋巴细胞 流式细胞术 细胞因子 

分 类 号：R725.7[医药卫生—儿科]