静注人免疫球蛋白对手足口病患儿中血清模式识别受体和炎症因子的影响  

Effects of intravenous human immunoglobulin on serum pattern recognition receptors and inflammatory factors in children with hand-foot-mouth disease

作　　者：王荣[1] 李永佳[2] 唐小清 刘桂君 熊学芹 李艳敏 WANG Kong;LI Yong-jia;TANG Xiao-qing;LIU Gui-jun;XIJONG Xue-qin;Yan-min(Dazhou Vocational and Technical College,Dazhou,Sichuan 635000,China)

机构地区：[1]达州职业技术学院临床医学系儿科教研室,四川达州635000 [2]达州市中心医院儿科,四川达州635000 [3]达州市妇幼保健院儿科,四川达州635000 [4]达州职业技术学院临床医学系妇产科教研室,四川达州635000

出　　处：《中华医院感染学杂志》2019年第24期3818-3821,3835,共5页Chinese Journal of Nosocomiology

基　　金：四川省教育厅自然科学重点科研基金资助项目(15ZA0365);四川省教育厅人文社会科学应用心理学研究项目(CSXL-720221)

摘　　要：目的探讨静注人免疫球蛋白对手足口病患儿中血清模式识别受体和炎症因子的影响。方法选择达州市中心医院和达州市妇幼保健院于2013年5月-2017年5月收治的手足口病患儿102例为研究对象,依据随机数字表法分为对照组51例与试验组51例。对照组患儿口服利巴韦林颗粒,试验组在对照组基础上静注人免疫球蛋白。两组疗程均为5 d。比较两组治疗疗效和症状消失时间,治疗前后血清模式识别受体和炎症因子变化。结果治疗后,试验组总有效率为94.12%,高于对照组76.47%(χ~2=6.331,P=0.012);试验组手足疱疹消退时间、体温恢复时间和口腔溃疡消退时间优于对照组(P<0.05);两组血清膜蛋白细胞分化抗原14(CD14)、树突状细胞相关性C型植物血凝素1(Dectin)和胶原凝集素表达下降,且试验组血清CD14、Dectin和胶原凝集素表达低于对照组;两组血清C-反应蛋白(C-reactive protein,CRP)、降钙素原(Procalcitonin,PCT)和白细胞介素-6(Interleukin-6,IL-6)表达下降,且试验组血清CRP、PCT和IL-6表达低于对照组(P<0.05)。结论静注人免疫球蛋白对手足口病患儿疗效明显,可降低模式识别受体表达及减轻炎症反应,值得临床借鉴。OBJECTIVE To investigate the effects of intravenous human immunoglobulin on serum pattern recognition receptors and inflammatory factors in children with hand-foot-mouth disease. METHODS The total of 102 children with hand-foot-mouth disease were enrolled from May 2013 to May 2017. They were divided into two groups according to the random number table method: 51 cases in the control group and 51 cases in the experimental group. Patients in the control group were given ribavirin granules orally, whereas those in the observation group was given ribavirin granules orally and human immunoglobulin. Both groups were treated for 5 days. The therapeutic effect and the time length of symptoms were compared between the two groups, and the variation of serum pattern recognition receptors and inflammatory factors before and after the treatment were also compared. RESULTS After the treatment, the total effective rate of the experimental group was 94.12%, which was significantly higher than that of the control group 76.47%(χ~2=6.331, P=0.012). The recovery time of hand and foot blisters, fever and oral ulcer of patients in the experimental group was significantly better than that in the control group(P<0.05). The expression of serum CD14, Dectin and collagen lectin significantly decreased in the two groups after the treatment(P<0.05). And these indexes in the experimental group were lower than that in the control group. The expressions of serum CRP, PCT and IL-6 decreased in the two groups after the treatment, and these indexes in the experimental group were significantly lower than that in the control group(P<0.05). CONCLUSION Intravenous injection of human immunoglobulin is effective in children with hand-foot-mouth disease. It can reduce the expression of pattern recognition receptor and alleviate inflammation, which is worthy of clinical reference.

关 键 词：人免疫球蛋白 手足口病 模式识别受体 炎症因子 

分 类 号：R725.1[医药卫生—儿科]