肠道病毒71感染的手足口病患儿体液免疫检测及应用价值  

Detection and application value of humoral immunity for HFMD children with enterovirus 71 infection

作　　者：韩宜姚 白敏[1] 

机构地区：[1]浙江省舟山医院妇幼保健院区,浙江舟山330902

出　　处：《中国医药导报》2013年第30期117-119,122,共4页China Medical Herald

基　　金：浙江省舟山市科技计划项目(编号2011C13046)

摘　　要：目的通过测定手足口病（HFMD）患儿机体血清炎症细胞因子如肿瘤坏死因子-α（TNF-01）、白细胞介素-6（IL-6）．免疫球蛋白（IgA、IgG、IgM）及补体C3、C4水平，以探讨HFMD患儿体液免疫与HFMD的关系。方法收集舟山医院妇幼保健院区2010年6月-2012年12月HFMD患儿50例，其中30例肠道病毒71（EV71）感染呈阳性，20例呈阴性。另选取同期20例健康体检儿为对照。血清免疫球蛋白如IgA、IgG,IgM和补体C3、C4水平采用放射性免疫扩散法测定，血清TNF-α、IL-6采用化学发光免疫分析法进行测定。结果EV71阳性感染的HFMD患儿血清TNF-α、IL-6、IgA、IgG、IgM及补体C3、C4水平依次为（66．0±11．2）ng／L、（44．3±7．7）ng／L、（0．50±0．37）g／L、（8．09±3．55）g／L、（1．47±0．70）g／L、（0．96±0．51）g／L、（0．21±0．07）g／L，与其他肠道病毒引起HFMD相应指标水平比较，差异无统计学意义（t=0．462、0．734、0．209、0．125、0．259、0．209、0．833，均P〉0．05），但EV71阳性感染组血清TNF—α、IL-6、IgA、IgG、IgM和补体C3、C4水平与对照组比较，差异均有统计学意义（t=20．398、19．496、4．319、2．756、2．379、2．146、3．148，均P〈0．05），其中IgA、IgG和补体C3、C4水平较对照组明显降低，而IgM、TNF—α、IL-6则明显升高。结论EV71感染HFMD患儿的体液免疫功能紊乱．TNF—α、IL-6参与了HFMD的病理过程，可为HFMD的临床诊断、疗效观察及预后判断提供一定的理论依据。Objective To determine the body serum inflammatory cytokines such as tumor necrosis factor-α （TNF-α, inter-leukin-6 （IL-6）, immunoglobulins （IgA, IgG, IgM） and complement C3, C4 levels in hand, foot and mouth disease （HFMD） children, in order to investigate the relationship of humoral immunity in children with HFMD. Methods 50 cases of HFMD children in Maternity and Child Health Hospital District of Zhoushan Hospital from June 2010 to December 2012, including 30 cases of enterovirus 71 （EV 71） infection with positive and 20 cases with negative. Another 20 healthy children were selected as controls. Serum immunoglobulins such as IgA, IgG, IgM and complement C3, C4 levels were determined by radioim-munoassay diffusion method, serum TNF-α, IL-6 were measured by chemiluminescent immunoassay. Results Compared with other indicators of enteroviruses cause HFMD appropriate level, EV71 infected HFMD children with positive serum TNF-α, IL-6, IgA, IgG, IgM and complement C3, C4 levels were （66.0±11.2） ng/L, （44.3 ±7.7） ng/L, （0.50±0.37） g/L, （8.09±3.55） g/L, （1.47±0.70） g/L, （0.96±0.51） g/L, （0.21±0.07） g/L respectively, the differences were not statistically significant （t = 0.462, 0.734, 0.209, 0.125, 0.259, 0.209, 0.833, all P 〉 0.05）. However, compared with control group, the differences in positive EV71 in-fection group of serum TNF-α, IL-6, IgA, IgG, IgM and complement C3, C4 levels were statistically significant （t = 20.398, 19.496, 4.319, 2.756, 2.379, 2.146, 3.148, all P 〈 0.05）, in which, IgA, IgG and complement C3, C4 levels were significantly lower than those in the control group, while IgM, TNF-α, IL-6 significantly increased. Conclusion EV71 infected HFMD children humoral immune is dysfunction, TNF-α and IL-6 involve in the pathological process of HFMD, and can provide a theoretical basis to the clinical diagnosis, efficacy and prognosis of HFMD.

关 键 词：肠道病毒71 手足口病 体液免疫 

分 类 号：R512.5[医药卫生—内科学]