手足口病患儿血清免疫球蛋白表达水平与疾病进展相关性分析

目的探讨轻症和重症手足口病(hand,foot and mouth disease,HFMD)患儿血清免疫球蛋白变化与疾病进展的相关性。方法选择本院2013年6月住院的轻症和重症HFMD患儿369例,其中轻症组259例,重症组(含危重型)110例;以同期30名体检正常的健康儿童为对照组。采用免疫比浊法检测各组血清免疫球蛋白(IgA、IgG、IgM)和补体C3、C4表达水平。比较各组及重症组肠道病毒71型(enterovirus 71,EV71)感染和非EV71感染患儿、柯萨奇病毒A16(coxsackievirus A16,CoxA16)感染和EV71感染患儿的血清免疫球蛋白表达水平。结果与对照组相比,重症组IgG、IgA和IgM水平显著升高,轻症组IgM水平显著升高;与轻症组相比,重症组IgG和IgA水平显著升高;重症组EV71感染患儿IgM水平显著高于非EV71感染患儿,其IgG和IgM水平显著高于CoxA16感染患儿;各组间补体C3、C4水平比较差异均无统计学意义。结论 HFMD患儿血清免疫球蛋白表达水平存在变化,随着病情进展,血清免疫球蛋白表达水平变化更加显著。重症患儿血清免疫球蛋白表达水平显著高于轻症患儿,重症患儿中EV71感染者较CoxA16感染者血清免疫球蛋白表达水平变化更加显著。

Relationship between serum immunoglobulin levels and disease progression in children with hand,foot and mouth disease

Objective To investigate the relationship between serum immunoglobulin levels and disease progression in mild and severe children with hand, foot and mouth disease （HFMD）. Methods A total of 369 HFMD children, admitted to our hospital during Jun. 2013, were divided into a mild group （n=259） and a severe group （n=110）. Thirty healthy children receiving physical ex-amination were selected as controls. Immune turbidimetry assay was used to detect the levels of serum IgA, IgG, IgM, C3 and C4. Serum immunoglobulin levels were compared among the mild group, the severe group and the control group, and between the severe children with enterovirus 71 （EV71） and without EV71 infection, and between the severe children with coxsackievirus A16 （CoxA16） and EV71 infection. Results As compared with the control group, the levels of IgG, IgA and IgM of the severe group and the level of IgM of the mild group increased significantly. As compared with the mild HFMD group, the levels of IgG and IgA of severe HFMD group increased significantly. The level of IgM of the severe children with EV71 infection was significantly higher than that of the severe children without EV71 infection, and the levels of IgG and IgA of the severe children with EV71 infection were signifi-cantly higher than those of the severe children with CoxA16 infection. The levels of C3 and C4 were not significantly different among the groups. Conclusion Serum immunoglobulin levels of HFMD children change, and they change significantly with disease progression. The levels of the severe HFMD children are significantly higher than those of the mild HFMD children. The levels of the severe children with EV71 infection change more significantly than those of the severe children with CoxA16 infection.