EV71病毒引起手足口病患儿免疫状态变化的研究

目的：探讨EV71病毒引起的手足口病患儿免疫状态变化。方法按照临床诊断和分型标准将手足口患儿分为普通型、重型和危重型三组，同时以健康儿童作为对照组。采集病例组和对照组的静脉血，分别用化学发光分析仪检测白介素-13（IL-13）和干扰素-γ（IFN-γ）；特定蛋白分析仪检测免疫球蛋白（IgG、IgA和IgM）；流式细胞仪检测T细胞亚群、B细胞和NK细胞的相对含量。结果（1）免疫球蛋白和细胞因子变化：手足口三型与健康对照组比较，IgG、IgA、IgM、IL-13和IFN-γ都增高，除普通型的IgG、IgA没有统计学意义以外，其它都差异有统计学意义（P＜0.01）；而手足口三型之间比较，随着病情的加重，五项指标的浓度也不断增高，差异都有统计学意义（P＜0.01）。（2）细胞免疫的变化：普通型组与健康对照组比较CD3＋、CD4＋、CD8＋稍微增高，差异无统计学意义（P＞0.05），CD16＋56＋、CD19＋增高，差异有统计学意义（P＜0.01）；其它两型与健康对照组比较， CD3＋、CD4＋、CD8＋、CD16＋56＋的含量都显著降低，而CD19＋显著增高，差异都有统计学意义（P＜0.01）；CD4＋/CD8＋的比值无显著变化，差异无统计学意义（P＞0.05）。手足口三型之间比较，随着病情的加重，CD3＋、CD4＋、CD8＋、CD16＋56＋的含量的不断降低，而CD19＋不断增高，差异都有统计学意义（P＜0.01）。结论 EV71感染所致 HFMD患儿出现细胞免疫、体液免疫和先天性免疫功能紊乱，并与疾病的严重程度有关。

Study of the changes of immune status in children with HFMD caused by EV71 virus

Objective To study the changes of immune status in children with HFMD caused by EV71 virus. Methods HFMD patients were divided into three groups, called the common type, the severe type and critical type,respectively,according to the clinical diagnosis and classification standards, meanwhile, healthy children were taken as a control group. Peripheral blood samples were collected from the case groups and control group, and the concentions of interleukin -13 （IL-13） and interferon-γ（IFN-γ） were tested by the chemiluminescence assay, immunoglobulin （IgG, IgA, and IgM） were also tested by the immunoturbidi-metric assay, as well as, the relative contents of T cell subsets, B cells and NK cells were tested by Flow cytometry. Results Com-pared the detected results of three types of HFMD with those of the control group, the levels of IgG, IgA, IgM, IL-13 and IFN-γwere significantly increased, all the differences were statistically significant（P＆lt;0.01）, except the difference of IgG, and IgA between the ordinary type and the control group. Moreover, compared with the three types of HFMD, the concentrations of five indicators were also increased as the disease becoming worsen, all the differences were statistically significant （P＆lt;0.01）. Compared the com-mon type group with the control group, the percentage of CD3＋, CD4＋, CD8＋were slightly increased, but the differences were not statistically significant （P＆gt;0.05）. Meanwhile, the percentage of CD16＋56＋and CD19＋were dramatically increased, the differences were statistically significant（P＆lt;0.01）. Compared the other two types with the control group, the percentage of CD3＋, CD4＋, CD8＋and CD16＋56＋were significantly decreased, but CD19＋was significantly increased , and all the differences were statistically significant （P＆lt;0.01）. However, the ratio of CD4＋/CD8＋did not change drastically, and there were no differences among all the groups（P＆gt;0.05）. Compared the three types of HFMD with each other, the percentage of CD3＋, CD4＋, CD8＋and CD16＋56＋were decreased continu-ously as the disease becoming worsen, while the CD19＋were increased constantly, all the differences were statistically significant （P＆lt;0.01）. Conclusion The children with HFMD caused by EV71 infection exist functional disorders of cell immunity, humoral im-munity and innate immune, and related with severity of the disease.