手足口病患儿细胞免疫功能低下的影响因素分析  

Influencing Factors of Low Cellular Immune Function in Children with Hand-foot-mouth Disease

作　　者：韩娟子 赵青[2] HAN Juanzi;ZHAO Qing(Department of Pediatrics,Shanxi Medical University,Taiyuan 030001,China;Department of Digestive Medicine,Shanxi Children′s Hospital,Taiyuan 030001,China)

机构地区：[1]山西医科大学儿科医学系,太原030001 [2]山西省儿童医院消化内科,太原030001

出　　处：《医学综述》2022年第4期828-832,共5页Medical Recapitulate

摘　　要：目的探讨手足口病(HFMD)患儿细胞免疫功能低下的影响因素。方法回顾性收集2014年1月至2016年12月山西省儿童医院收治的1291例HFMD患儿的临床资料,根据健康儿童CD3^(+)T淋巴细胞百分比参考值65%~79%分为细胞免疫功能低下组(CD3^(+)T淋巴细胞百分比<65%)和未下降组(CD3^(+)T淋巴细胞百分比65%~79%),记录患儿的性别、发病-就诊时间间隔、血液化验指标、病情程度、肠道病毒分型,分析HFMD患儿细胞免疫功能低下的独立危险因素。结果在1291例HFMD患儿中,细胞免疫功能低下836例,未下降455例。两组发病-就诊时间间隔、病情程度、中性粒细胞绝对值、中性粒细胞百分比、C反应蛋白(CRP)、乳酸脱氢酶(LDH)、肌酸激酶、肠道病毒分型比较差异均有统计学意义(P<0.05或P<0.01)。多因素分析结果显示,CRP、LDH、病情程度、肠道病毒分型是HFMD细胞免疫功能低下的影响因素(OR=1.821,95%CI 1.280~2.591,P=0.005;OR=1.903,95%CI 1.413~2.562,P<0.001;OR=1.527,95%CI 1.092~2.392,P=0.031;OR=1.397,95%CI 1.228~1.588,P<0.001)。结论CRP、LDH、重症、肠道病毒A71是HFMD患儿细胞免疫功能低下的独立危险因素,可为临床诊疗提供新方向。Objective To study the influencing factors of low cellular immune function in children with hand-foot-mouth disease(HFMD).Methods Clinical data from a total of 1291 children with HFMD admitted to Shanxi Children′s Hospital from Jan.2014 to Dec.2016 were collected in this study.According to the reference value of the percentage of CD3^(+)T lymphocytes in healthy children(65%-79%),they were divided into a low cellular immune function group(the percentage of CD3^(+)T lymphocytes<65%)and a non-decreased cellular immune function group(the percentage of CD3^(+)T lymphocytes 65%-79%),and the gender,time interval between onset and treatment,blood test indexes,degree of illness and enterovirus types were recorded,to analyze the independent risk factors of low cellular immune function in HFMD children.Results Among 1291 children with HFMD,836 had low cellular immune function and 455 did not.There were statistically significant differences between the two groups in the time interval between onset and visit,degree of illness,neutrophilic granulocyte,neutrophil ratio,C-reactive protein(CRP),lactate dehydrogenase(LDH),creatine kinase and enterovirus typing(P<0.05 or P<0.01).Multivariate analysis results indicated:CRP,LDH,severe stage,enterovirus typing were independent risk factors for low cellular immune function in HFMD children(OR=1.821,95%CI 1.280-2.591,P=0.005;OR=1.903,95%CI 1.413-2.562,P<0.001;OR=1.527,95%CI 1.092-2.392,P=0.031;OR=1.397,95%CI 1.228-1.588,P<0.001).Conclusion CRP,LDH,severe stage,and enterovirus 71 are independent risk factors of low cellular immune function in children with HFMD,which can provide new directions for the clinical diagnosis and treatment.

关 键 词：手足口病 CD3^(+)T淋巴细胞 细胞免疫 儿童 危险因素 

分 类 号：R512.5[医药卫生—内科学]