手足口病患儿外周血 Th17、CD^4＋CD25^＋Treg、HLA-DR mRNA 表达的研究  

Expression of Th17, CD^4＋CD25^＋Treg, HLA-DR mRNA in peripheral blood of children with hand, foot and mouth diseases

作　　者：刘晶晶[1] 李庆彦[1] 李庆方[1] 刘春华[1] 贺玉凯[1] 陶昌明 

机构地区：[1]山东省聊城市人民医院感染病科,252000

出　　处：《中华临床感染病杂志》2015年第3期263-268,共6页Chinese Journal of Clinical Infectious Diseases

摘　　要：目的：探讨EV71阳性手足口病患儿外周血Th17、CD^4＋CD25^＋Treg、HLA-DR mRNA的表达及临床意义。方法采用分层随机抽样的方法选取2014年2至10月山东省聊城市人民医院收治的手足口病患儿60例，其中普通组、重症组和危重症组各20例，并选择同期在本院体检的20名儿童作为健康对照组。所有患儿均使用利巴韦林（10mg／kg）抗病毒治疗。采用流式细胞术检测外周血Th17和CD^4＋CD25^＋Treg的表达，采用反转录聚合酶链反应（ RT-PCR）检测HLA-DR mRNA的表达。采用方差分析和SNK-q检验比较各组间Th17、CD4＋CD25＋Treg以及HLA-DR mRNA的表达，并采用Pearson法分析HLA-DR mRNA表达与外周血Th17和CD^4＋CD25^＋Treg表达的相关性。结果与健康对照组比较，治疗第1天时，手足口病患儿外周血Th17表达升高（F＝310．4，P＜0．01），CD^4＋CD25^＋Treg和HLA-DR mRNA表达下降（F＝81．5和545．4，P＜0．01）。经过治疗，普通组、重症组和危重症存活组Th17逐渐下降，CD^4＋CD25^＋Treg和HLA-DR mRNA水平上升，但危重症死亡组患儿外周血Th17水平却升高，CD^4＋CD25^＋Treg和HLA-DR mRNA水平下降。治疗第10天时，普通组、重症组、危重症存活组的Th17和CD^4＋CD25^＋Treg水平与健康对照组比较差异无统计学意义（P＞0．05），但危重症死亡组Th17水平仍进行性升高，CD^4＋CD25^＋Treg水平继续下降，与存活组相比差异有统计学意义（ t＝16．4和12．0，P＜0．05）；普通组和重症组HLA-DR mRNA水平与健康对照组相比差异无统计学意义，危重症存活组HLA-DR mRNA水平虽然呈上升趋势，但与普通组和重症组相比存在统计学差异（P＜0．05），不过明显高于危重症死亡组水平（t＝7．8，P＜0．05）。 Pearson相关性分析发现， HLA-DR mRNA水平与Th17水平呈负相关（r＝-0．770，P＜0．01），与CD^4＋CD25^＋Treg水平呈正相关（ r＝0．883，P＜0．01）。结�Objective To investigate the expressions of Th17,CD^4＋CD25^＋Treg, HLA-DR mRNA in peripheral blood of children with EV71-induced hand, foot and mouth diseases （ HFMD ） and their clinical significance.Methods Stratified random sampling was used to select 60 children with HFMDs from Liaocheng People’s Hospital from February to October, 2014, including 20 mild, 20 severe and 20 critically ill cases.Twenty healthy children were also enrolled as the control group.All the children with HFMDs were given ribavirin （10 mg/kg） for the treatment.The percentages of Th17 and CD^4＋CD25^＋Treg cells in CD4^ ＋T cells of peripheral blood were determined by flow cytometry, and the expression of HLA-DR mRNA in peripheral blood mononuclear cells was detected by reverse transcription polymerase chain reaction （ RT-PCR）.Analysis of variance and SNK-q test were used to compare the expressions of Th17, CD^4＋CD25^＋Treg and HLA-DR mRNA among groups, and Pearson correlation analysis was performed to reveal the correlations between HLA-DR mRNA and Th17, CD^4＋CD25^＋Treg.Results Compared with the control＆amp;nbsp;group, the expression of Th17 was increased, while CD^4＋CD25^＋Treg and HLA-DR mRNA expressions were decreased in children with HFMDs on d1 of treatment （F=310.4, 81.5 and 545.4, P〈0.01）.After treatment, Th17 levels in mild group, severe group and surviving children of critically ill group were decreased, CD^4＋CD25^＋Treg and HLA-DR mRNA expressions were increased, while in fatal cases, Th17 level was still on the rise, and CD^4＋CD25^＋Treg and HLA-DR mRNA expressions were still decreasing. After 10 d of treatment, the difference in Th17 and CD^4＋CD25^＋Treg levels among mild group, severe group, surviving children of critically ill group and control group was of no statistical significance （ P 〉0.05）, but Th17 level in fatal was still higher and CD^4＋CD25^＋Treg level was still lower than those in control group （t=16.4 and 12.0, P〈0.05）.After 10 d of treatment, HLA-DR

关 键 词：手足口病 TH17 CD^4+CD25^+Treg HLA—DR 

分 类 号：R725.1[医药卫生—儿科]