神经内分泌指标对EV71感染手足口病的诊断价值  

Value of neuroendocrine indices in the diagnosis of hand-foot-mouth disease infected by EV71

作　　者：王宇丹[1] 赵仕勇[2] 吴烨[1] 

机构地区：[1]浙江省湖州市中心医院儿科,浙江湖州313000 [2]杭州市第六人民医院儿科,浙江杭州310023

出　　处：《中国现代医生》2015年第9期16-18,22,共4页China Modern Doctor

基　　金：浙江省医药卫生平台骨干人才计划(2012KYB159)

摘　　要：目的探讨神经内分泌以及免疫学部分指标在EV71感染所致手足口病患儿病情评估中的价值。方法将我院收治的210例EV71感染所致小儿手足口病分为普通患儿112例(A组)、重症患儿57例(B组)和危重型患儿41例(C组);另选择同期在我院检查的健康患儿80例作为对照组;分别检测各组患儿皮质醇(COR)、β-内啡肽(β-EP)、免疫球蛋白、淋巴细胞亚群、B淋巴细胞、自然杀伤细胞(NK细胞)、白细胞介素-13(IL-13)、干扰素-γ(IFN-γ)水平。结果 A、B、C三组COR、β-EP、IL-13、IFN-γ、NK细胞(CD19+)水平显著高于对照组(P<0.05);B组、C组Ig G、Ig A、Ig M水平显著高于对照组(P<0.05);随着病情的加重,各指标水平逐渐升高。B组、C组CD3+、CD4+、CD8+等T细胞亚群及B淋巴细胞(CD16+CD56+)水平显著低于对照组,随着疾病的加重,CD3+、CD4+、CD8+、CD16+CD56+显著降低,差异有统计学意义(P<0.05)。结论 EV71感染所致手足口病伴有细胞免疫、体液免疫等免疫功能紊乱,并与疾病进展密切相关;对患儿进行免疫指标和神经内分泌指标监测,有助于评估患儿的病情。Objective To explore the value of neuroendocrine indices and some immune indices in the assessment of conditions for children patients with hand-foot-mouth disease infected by EV71. Methods All 210 children patients with hand-food-mouth disease infected by EV71 who were admitted to our hospital were divided into three groups, 112 normal patients （group A）, 57 severe patients （group B） and 41 critical patients （group C）; 80 healthy children who received examination in our hospital during the same period of time were selected as control group; levels of COR, I^-EP, immune globulin, lymphocyte subpoputation, B lymphocytes, natural killer cells （NK cells）, IL-13, and IFN-~/were tested in each group. Results Levels of COR, I3-EP, IL-13, IFN-~ and NK cells（CD19~） in group A, B and C were significantly higher than those in control group（P〈0.05）; levels of IgG, IgA and IgM in group B and C were significantly higher than those in control group（P〈0.05）; With the conditions became severe, the level of each index gradually rose. Levels of subpopulation of T cells such as CD3＋, CD4＋, and CD8＋and B lymphoeytes （CD16＋ CD56＋） in group B and C were significantly lower than those in control group, and those levels declined with the con- dition went severe. The differences between groups were statistically significant （P〈0.05）. Conclusion Hand-foot- mouth disease infected by EV71 are complicated with immune dysfunction such as cell-mediated immunity and hu- moral immunity, which are closely related to disease progress. Therefore, the supervision on immune indices and neu- roendocrine indices for children patients is helpful in assessing patients＂ conditions.

关 键 词：神经内分泌指标 免疫学指标 肠道病毒71型 手足口病 

分 类 号：R725.1[医药卫生—儿科]