手足口病患儿早期检查免疫功能及超敏C反应蛋白的临床意义

目的探讨手足口病患儿（HFMD）早期检查免疫功能及超敏C反应蛋白（hs CRP）的临床意义。方法选取经临床确诊为重症HFMD患儿60例作为研究对象（重症HFMD组），并与同期在接受健康体检的正常儿童100例进行对照研究（对照组），采用免疫比浊法检测两组患儿的hs CRP水平及免疫球蛋白浓度（IgA、IgG、IgM、C3及C4），T淋巴细胞亚群水平（CD3+、CD4+及CD8+）。结果重症HFMD组患儿急性期、恢复期的hs CRP及白细胞计数（WBC）水平均显著高于对照组（P<0.01）；重症HFMD组患儿恢复期的hs CRP及WBC水平均显著低于急性期，且显著高于对照组（P<0.01）；重症HFMD患儿急性期、恢复期的IgA水平显著低于对照组（P<0.05）；重症HFMD患儿急性期、恢复期IgG、C3、C4水平显著高于对照组（P<0.05）；重症HFMD组患儿急性期及恢复期的CD3+水平、CD4+水平及CD4+/CD8+比值均显著低于对照组（P<0.05）；重症HFMD组患儿恢复期的CD3+水平显著高于急性期水平（P<0.05）。结论hs CRP的监测可了解重症HFMD患儿的炎症及心肌损伤状况，重症HFMD组患儿急性期存在明显的细胞免疫下降及体液免疫功能紊乱，重症HFMD组患儿恢复期的体液免疫、细胞免疫及炎症程度逐步趋于正常。

Clinical significance of early detection of highly sensitivity C-reactive protein and immune function in children with hand foot and mouth disease

ObjectiveTo explore the clinical significance of highly sensitivity C reactive protein (hs CRP) and immune function in children with hand foot and mouth disease (HFMD). MethodsA total of 60 children with severe HFMD were selected as research group， and as control group， 100 cases of healthy children were enrolled. Using the immune turbidimetry， hs CRP， immunoglobulin (IgA， IgG， IgM， C3 and C4) and T lymphocyte subsets (CD3+， CD4+ and CD8+) were detected. Resultshs CRP and WBC in acute phase and recovery phase in research group were significantly higher than those in control group (P<0.01). hs CRP and WBC in recovery phase were significantly lower than those in acute phase， however，and they were significantly higher than those in control group (P<0.01). IgA in acute phase and recovery phase in observation group was significantly lower than that in control group (P<0.05). IgG， C3 and C4 in acute phase and recovery phase in observation group were significantly higher than those in control group (P<0.05). CD3+， CD4+ and CD4+/CD8+ ratio in acute phase and recovery phase in observation group were significantly lower than those in control group (P<0.05). CD3+ in recovery phase was significantly higher than that in the acute phase of observation group (P<0.05). ConclusionInflammation and myocardial injury can be detected in children with HFMD by hs CRP monitor， obviously lower function in cellular immunity and humoral immunity can be observed in acute phase of severe children with HFMD and in the recovery phase， the humoral immunity， cellular immunity and inflammation become gradually normal.