CoxA16感染手足口病患儿免疫球蛋白、T细胞亚群变化的研究  

Changes of serum immunoglobulins and peripheral blood T lymphocyte subsets in children with hand- foot- mouth disease caused by Cox A16

作　　者：乔国昱 何亚萍[2] 杜潘艳[2] 张国栋[1] 吴丽丽[1] 王振荣[2] 

机构地区：[1]唐山市协和医院检验科,河北唐山063000 [2]唐山市妇幼保健院检验科

出　　处：《实用预防医学》2015年第5期553-555,共3页Practical Preventive Medicine

基　　金：唐山市科技局计划指导项目(111302074b)

摘　　要：目的检测Cox A16感染手足口病患儿血清免疫球蛋白、外周血T细胞亚群的变化,探讨Cox A16引起手足口病的致病机制。方法采用实时荧光PCR检测2013年5月-2014年5月咽拭子标本为Cox A16阳性患儿78例。按疾病严重程度分为重症病例组和普通病例组,另选40例健康体检儿童为健康对照组。采用免疫比浊法检测血清Ig M、Ig A、Ig G;流式细胞仪测定T细胞亚群,对检测结果进行比较。结果重症病例组患儿血清Ig M、Ig A较普通病例组和健康对照组减少,差异有统计学意义(tIg M=3.614、4.127;tIg A=3.152、3.873,P<0.05),普通病例组Ig G含量高于重症病例组和健康对照组,差异有统计学意义(tIg G=2.951、3.236,P<0.05);与普通病例组和健康正常对照组比较,重症病例组T细胞亚群CD3+、CD4+、CD4+/CD8+比例降低,CD8+比例升高,差异有统计学意义(tCD3+=3.314、4.247;tCD4+=3.124、4.043;tCD4+/CD8+=3.251、3.867;tCD8+=3.326、3.915,P<0.05)。结论 Cox A16病毒感染后,患儿机体体液免疫受抑制,细胞免疫功能降低,可能与其致病机制有关。Objective To investigate the immunological pathogenic mechanisms of Coxsackievirus A16（ Cox A16） by measuring the changes of serum immunoglobulins and peripheral blood T lymphocyte subsets in children with hand- foot- mouth disease（ HFMD） caused by Cox A16. Methods Seventy- eight children with positive results in the detection of Cox A16 in throat swabs by teal- time fluorescent PCR were recruited from May 2013 to May 2014. They were divided into severe case group and ordinary case group according to the severity of the disease,with 40 healthy children receiving physical examination in the same hospital during the same period serving as controls. Immunoglobulins were measured by immunoturbidimetry,and T lymphocyte subsets were detected by flow cytometry. Results Serum Ig M and Ig A in the children in the severe case group decreased remarkably when compared with those in the ordinary case group and the control group（ tIg M= 3. 614,4. 127; tIg A= 3. 152,3. 873,all P 〈0. 05）. However,Ig G in the ordinary case group was significantly higher than that in the severe case group and the control group（ tIg G= 2. 951,3. 236,both P 〈0. 05）. The rates of T lymphocyte subsets CD3＋,CD4＋and CD4＋/ CD8＋in the severe case group were significantly lower than in the ordinary case group and the control group（ tCD3 ＋= 3. 314,4. 247; tCD4 ＋= 3. 124,4. 043;tCD4 ＋ / CD8 ＋= 3. 251,3. 867,all P 〈0. 05）,while CD8＋was higher tCD8 ＋= 3. 326,3. 915,both P 〈0. 05）. Conclusions Cellular immunity and humoral immunity are inhibited in children infected with HFMD caused by Cox A16,which might be related to its pathogenic mechanism.

关 键 词：手足口病 COXA16 免疫球蛋白 T细胞亚群 

分 类 号：R512.5[医药卫生—内科学]