共刺激分子OX40和OX40L在重症手足口病患儿外周血中的表达及意义  

Expressions and Significance of Costimulatory Molecules OX40 and OX40L in Peripheral Blood of Children with Severe Hand-Foot-Mouth Disease

作　　者：王淼[1] 付书琴[2] 宋春兰 WANG Miao;FU Shuqin;SONG Chunlan(Department of Pediatrics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;General Internal Medicine Department,Children’s Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院儿科,河南郑州450000 [2]郑州大学附属儿童医院普通内科,河南郑州450000

出　　处：《河南医学研究》2023年第10期1754-1757,共4页Henan Medical Research

摘　　要：目的 研究重症手足口病(HFMD)患儿外周血中共刺激分子OX40、OX40L的表达并探讨其临床价值。方法 选取2019年1月至2022年8月郑州大学附属儿童医院收治的肠道病毒71型(EV71)感染并确诊为HFMD的144例患儿,根据病情轻重程度分为轻症组(95例)及重症组(49例)。同时选取50例同年龄段健康体检儿童为对照组。检测所有入组儿童外周血标本中CD4^(+) T细胞OX40及CD14^(+)单核细胞上OX40L的表达。对HFMD患儿进行小儿危重病例评分(PCIS),分析HFMD患儿PCIS与OX40和OX40L表达间的相关性。结果 HFMD患儿的OX40和OX40L的表达水平均高于对照组,其中重症组最高(P<0.05);相关性分析显示,HFMD患儿OX40的表达与PCIS有相关性(r=-0.729,P<0.05)。比较外周血OX40、OX40L、白细胞计数(WBC)和白介素-6(IL-6)对重症HFMD的诊断效能,OX40的曲线下面积(AUC)最大,为0.844(95%CI:0.780~0.908),诊断重症HFMD效能较高。结论 OX40、OX40L在HFMD患儿的外周血中表达升高,在HFMD发病过程中发挥重要作用,且OX40可能与疾病的严重程度相关,可作为重症HFMD的预测指标之一,对早期识别重症HFMD患儿具有重要意义。Objective To explore the expression of costimulatory molecules OX40 and OX40L in peripheral blood of children with hand-foot-mouth disease(HFMD),and analyze their clinical value.Methods A total of 144 children infected with enterovirus 71(EV71)and diagnosed as HFMD in Children’s Hospital Affiliated to Zhengzhou University from January 2019 to August 2022 were selected.They were divided into mild group(95 cases)and severe group(49 cases)according to the severity of the disease.At the same time,50 healthy children of the same age were selected as the control group.The expression of OX40 on CD4+T cells and OX40L on CD14+monocytes in peripheral blood was detected.The pediatric critical illness score(PCIS)was performed on children with HFMD,and the correlation between PCIS and the expression of OX40 and OX40L in children with HFMD was analysed.Results The expressions of OX40 and OX40L in HFMD children were higher than those in the control group,and the expression level was highest in the severe group(P<0.05).The expression of OX40 was correlated with PCIS score(r=-0.729,P<0.05).The efficacy of peripheral blood OX40,OX40L,white blood cell(WBC)and interleukin-6(IL-6)in the diagnosis of severe HFMD was compared.The maximum area under curve(AUC)was OX40,with a value of 0.844(95%CI:0.780-0.908),indicating a higher efficacy in the diagnosis of severe HFMD.Conclusion The expression of OX40 and OX40L in the peripheral blood of children with HFMD is increased,which plays an important role in the pathogenesis of HFMD,and OX40 may be related to the severity of the disease,which can be used as one of the predictors of severe HFMD,and has important significance for the early identification of children with severe HFMD.

关 键 词：手足口病 OX40 0X40L 儿童 

分 类 号：R725.1[医药卫生—儿科]