危重症手足口病患儿108例免疫功能分析  

Analysis on immunologic function of 108 cases of children with critical hand,foot and mouth disease

作　　者：邓慧玲[1] 吴晓康[2] 张玉凤[1] 马超锋[3] 余鹏博[4] 陈海龙[3] Deng Huiling Wu Xiaokang Zhang Yufeng et al(Second Department of Infection, Xi’ an Children’ s Hospital （Xi’ an 710003)

机构地区：[1]西安市儿童医院感染二科,西安710003 [2]西安交通大学第二附属医院,西安710004 [3]西安市疾病预防控制中心,西安710054 [4]陕西省疾病预防控制中心,西安710054

出　　处：《陕西医学杂志》2017年第5期556-558,共3页Shaanxi Medical Journal

基　　金：陕西省科学技术研究发展项目(2011K12-82);陕西省科技统筹重点产业创新链工程计划项目(2016KTZDSF02-04);西安市科学技术局医疗卫生研究项目(2016052SF/YX08)

摘　　要：目的:探讨手足口病危重症患儿的免疫功能变化及免疫学发病机制。方法:将220例经临床和实验室确诊为EV_(71)感染的手足口病患儿根据病情分为普通型组(112例)和危重症组(108例),以同期门诊健康体检儿50例作为正常对照组,采用流式细胞术检测各组患儿血液中T淋巴细胞(CD_3^+)、B淋巴细胞(CD_(19)^+)和NK(CD_(16)^+CD_(56)^+)细胞百分比的变化。结果:手足口病患儿尤其危重症组血液中T淋巴细胞(CD_3^+)和NK(CD_(16)^+CD_(56)^+)细胞百分比较正常对照组显著下降(P<0.05),B淋巴细胞(CD_(19)^+)百分比较正常对照组显著升高(P<0.05);普通型和危重症患儿恢复期T淋巴细胞(CD_3^+)较急性期显著增加(P<0.05),B淋巴细胞(CD_(19)^+)和急性期相比无显著差异(P>0.05),而NK(CD_(16)^+CD_(56)^+)细胞却显著降低(P<0.05)。结论:手足口病患儿存在细胞免疫和体液免疫功能紊乱,对手足口病患儿免疫功能了解有助于判断病情、指导治疗。Objective： To investigate immunologic functional status and immunological pathogenesis of pa-tients with critical hand, foot and mouth disease. Methods： 220 children with hand, foot and mouth disease were collected and confirmed as EV71 positive through clinical and laboratory diagnosis. According to the patient＇s condi-tion, samples were divided into normal group （112 cases） and critical group （108 cases）. At the same time, another 50 healthy children were recruited as controls. The levels of T cell subgroups（CD3 ＋, CD19 ＋ and CD16 ＋ CD56 ＋ ） in the blood of children were detected by flow cytometry. Results： The percentages of T lymphocytes （CD3＋） and NK cells （CD16 ＋ CD56 ＋ ） in the blood decreased in HFMD patients versus those in controls（P〈C〇 . 05） , and B lymphocyte （CD19 ＋ ） was just the opposite （P〈C〇 . 05） , especially in critical cases. In recovery stage, the percentages of T lym-phocytes （CD3 ＋ ） in the blood increased significantly compared to acute stage（P〈C0. 05） ,and no significant difference in the percentages of B lymphocytes （CD19 ＋ ） , while the percentages of NK cells （CD16 ＋ CD56 ＋ ） were dramatically decreased（P〈0. 05）. Conclusion： Dysfunction of cellular immunity and humoral immunity occur to the patients with hand, foot and mouth disease. To know more about immunity of children with hand, foot and mouth disease is beneficial to judge the condition of disease and guide the therapy.

关 键 词：手足口病/血液 T淋巴细胞/代谢 B淋巴细胞/代谢 危重病 儿童 

分 类 号：R725.1[医药卫生—儿科]