丙种球蛋白对手足口病患者血循环中炎症细胞因子水平的影响  

Effects of immunoglobulin on circulating proinflammatory cytokines in children with hand-foot-mouth disease

作　　者：程红球[1] 黄彩华[1] 刘卫东[1] 姚展成[1] 于桂琴[1] 

机构地区：[1]汕头大学医学院第二附属医院感染科,广东汕头515041

出　　处：《中国病理生理杂志》2013年第3期546-548,共3页Chinese Journal of Pathophysiology

基　　金：广东省医学科研基金资助项目(No.B2009177)

摘　　要：目的:从炎症反应综合征角度阐明静脉注射丙种球蛋白(IVIG)治疗手足口病的作用机制。方法:64例早期重症手足口病患儿随机分为IVIG+病毒唑治疗组及病毒唑治疗组,病毒唑治疗组32例给予病毒唑抗病毒和对症支持治疗,IVIG+病毒唑治疗组32例在病毒唑抗病毒和对症支持治疗基础上加用IVIG,连续应用3 d,比较治疗前后肿瘤坏死因子α(TNF-α)、C-反应蛋白(CRP)和白细胞介素6(IL-6)的变化。另选32例正常儿童为对照组。结果:(1)IVIG+病毒唑治疗组和病毒唑治疗组患儿与正常儿童组比较,血中TNF-α、CRP和IL-6水平明显升高,差异具有统计学意义(均P<0.01);(2)治疗前IVIG+病毒唑治疗组与病毒唑治疗组患儿体内TNF-α、CRP和IL-6水平比较,差异无统计学意义(均P>0.05);(3)治疗后IVIG+病毒唑治疗组比病毒唑治疗组患儿体内TNF-α、CRP和IL-6水平下降明显,经比较有统计学意义(P<0.01或P<0.05)。结论:全身炎症反应综合征是手足口病的发病机制之一,IVIG可治疗儿童手足口病,其机制可能与减少TNF-α和IL-6等细胞因子生成有关。AIM： To study the mechanism of intravenous administration of immunoglobulin for treatment of hand-foot-mouth disease. METHODS： Sixty-four children with hand-foot-mouth disease were randomly divided into treat- ment group and control group. The children in control group （n = 32） were treated with ribavirin and given normal support- ive therapy. The children in treatment group （ n = 32） were given ribavirin and normal supportive therapy plus intravenous administration of immunoglobulin （500 mg· kg-1· d-1） for 3 d. The levels of TNF-α, C-reactive protein （CRP） and IL- 6 in venous blood were observed. RESULTS： The levels of TNF-α, CRP and IL-6 in treatment group and control group were all higher than those in the normal children. The levels of TNF-α, CRP and IL-6 in treatment group were similar to those in control group before treatment. The levels of TNFα, CRP and IL-6 in treatment group were significantly lower than those in control group after treatment with immunoglobulin for 3 d. CONCLUSION： The systemic inflammatory re- sponse syndrome is one of the possible mechanisms of hand-foot-mouth disease. Intravenous administration of immunoglobu- lin decreases the proinflammatory cytokines in the patients with hand-foot-mouth disease.

关 键 词：手足口病 免疫球蛋白 全身炎症反应综合征 细胞因子类 

分 类 号：R363.2[医药卫生—病理学]