手足口病脑炎患儿脑脊液中细胞因子水平的比较  

Comparison of levels of cytokines in cerebrospinal fluid from children with HFMD encephalitis caused by enteroviruses

作　　者：刘晶晶[1] 陶昌明 张迎迎 李庆彦[1] LIU Jing-jing;TAO Chang-ming;ZHANG Ying-ying;LI Qing-yan(Division of Infectious Diseases,Liaocheng People′s Hospital,Liaocheng 252000,Shandong Province, China)

机构地区：[1]聊城市人民医院感染科,山东聊城252000

出　　处：《微生物学免疫学进展》2019年第1期36-39,共4页Progress In Microbiology and Immunology

摘　　要：目的探讨不同病原体(CV-A6、CV-A16、EV-A71)所致手足口病脑炎患儿脑脊液中IL-6、IL-10、TNF-α、IFN-γ水平及意义。方法采用随机抽样的方法选取2018年3—5月在医院感染科收治的HFMD患儿,其中EV-A71组90例,CV-A6组77例,CV-A16组65例,选择同期高热惊厥患儿20例作为对照(高热惊厥组)。患儿入院后1～2 d行腰椎穿刺术,收集脑脊液2 mL,用流式细胞检测术分别检测细胞因子IL-6、IL-10、TNF-α、IFN-γ水平。结果 EV-A71组、CV-A6组、CV-A16组IL-6水平均明显高于高热惊厥组(t分别为6.224、7.579、6.667,P!0.05),且组间差异有统计学意义(F=18.631,P<0.05)。EV-A71组、CV-A6组、CV-A16组IL-10水平均高于高热惊厥组,差异具有统计学意义(t分别为5.387、3.227、3.084,P!0.05),且组间差异有统计学意义(F=17.480,P<0.05)。EV-A71组、CV-A6组、CV-A16组TNF-α水平与高热惊厥组差异均无统计学意义(t=-1.071、1.498、0.400,P>0.05),组间差异有统计学意义(F=6.069,P<0.05)。EV-A71组、CV-A6组、CV-A16组IFN-γ水平均高于高热惊厥组,差异具有统计学意义(t分别为4.718、7.303、8.919,P!0.05),且组间差异有统计学意义(F=16.566,P<0.05)。结论 EV-A71、CV-A6、CV-A16所致重症HFMD患儿脑脊液中IL-6、IL-10、IFN-γ均升高,表明在这3种不同病原体所致HFMD患儿脑炎中,IL-6、IL-10、IFN-γ均起到重要作用。其中,IL-6、IFN-γ明显升高,可作为疾病严重程度的评价指标。Objective To explore the levels and significance of IL-6, IL-10, TNF-α and IFN-γ in the cerebrospinal fluid of children suffered from HFMD (hand foot and mouth disease encephalitis) caused by different pathogens including CV-A6, CV-A16 and EV-A71. Methods The random sampling was used to select children with HFMD from March to May 2018, including 90 cases in EV-A71 infection, 77 cases in CV-A6 infection, 65 cases in CV-A16 infection group, respectively, in the same time to select 20 cases of convulsion children with high fever as the control group. The tested children were received lumbar puncture at 1 or 2 days after admission, collected CSF 2 mL, and detected the levels of IL-6, IL-10, TNF-α and IFN-γ cytokines by flow cytometry microsphere assay. Results The levels of IL-6 in each group were significantly higher than those in the febrile convulsion group ( t = 6.224, 7.579, 6.667, P <0.05), and the difference between the two groups had a statistical significance ( F =18.631, P <0.05). The levels of IL-10 in all groups were significantly higher than those in febrile convulsion group ( t = 5.387, 3.227, 3.084, P <0.05), and the difference between groups had a statistical significance ( F =17.480, P <0.05). The level of IFN-γ in each group with HFMD was significantly higher than that in febrile convulsion group ( t = 4.718, 7.303, 8.919, P <0.05), and the difference between groups had a statistical significance ( F =16.566, P <0.05). There was no a significant difference in the level of TNF-α between the HFMD group and the febrile convulsion group ( t =-1.071, 1.498, 0.400, P > 0.05), and the difference between the two groups had a statistical significance( F =6.069, P <0.05). Conclusions IL-6, IL-10 and IFN-γ in CSF of children with severe HFMD caused by EV-A71, CV-A16 and CV-A6 were significantly increased, indicating that IL-6, IL-10 and IFN-γ played an important role in HFMD encephalitis caused by the three kinds of pathogens. The abnormal increase of IL-6 and IFN-γ was more obvious, which can be used

关 键 词：手足口病 脑炎 脑脊液 细胞因子 

分 类 号：R725.1[医药卫生—儿科]