手足口病患儿血清免疫球蛋白、循环脱氧核糖核酸的表达及临床意义

目的研究手足口病患儿血清免疫球蛋白、循环脱氧核糖核酸(cf DNA)的表达及临床意义。方法将2017年1月-2018年7月于本院接受诊治的148例手足口病患儿作为研究组,根据患儿病情严重程度分成轻症型90例、重症型58例;另选择同期于本院接受健康体检的80例正常儿童作为对照组。选择免疫透射比浊法对2组儿童的血清免疫球蛋白(IgA、IgG、IgM)进行测定,并经双重荧光定量PCR法测定血清循环脱氧核糖核酸表达水平。结果研究组血清IgA、IgG表达水平低于对照组,但血清IgM表达水平均高于对照组,差异有统计学意义(P<0.05);研究组血清cfDNA表达水平高于对照组,差异有统计学意义(P<0.05);重症型手足口病患儿的血清IgA、IgG表达水平均低于轻症型患儿,但血清IgM、cfDNA表达水平高于轻症型患儿,差异有统计学意义(P<0.05)。结论手足口病患儿的血清IgA、IgG表达水平降低,血清IgM、cfDNA表达水平升高,积极测定血清免疫球蛋白、cfDNA表达水平能够为临床诊断手足口病、评估病情的严重程度提供信息。

Clinical expression and significance of serum immunoglobulin and circulating DNA in children with hand-foot-mouth disease

Objective To study the clinical expression and significance of serum immunoglobulin and circulating deoxyribonucleic acid(cfDNA)in children with hand-foot-mouth disease.Methods A total of 148 cases of children with hand-foot-mouth disease who were treated in our hospital from January 2017 to July 2018 were included in the study group.According to the severity of the disease,the entire patient was divided into 90 cases of mild type and 58 cases of severe type.Another 80 cases of normal children who received a physical examination at the same time as the healthy control group were selected.The serum immunoglobulins(IgA,IgG,IgM)were measured by immunoturbidimetric assay in two groups of children,and serum circulating DNA expression levels were determined by double fluorescent quantitative PCR.Results The serum levels of IgA and IgG in the study group were lower than those in the control group,but the serum IgM expression level was higher than that in the control group(P<0.05).The serum cfDNA level of the study group was higher than that of the control group,and the difference was statistically significant(P<0.05).The serum IgA and IgG levels were significantly lower in children with severe hand-foot-mouth disease than in children with mild disease,but serum IgM and cfDNA levels were higher than those in mild children,with the differences statistically significant(P<0.05).Conclusion The levels of serum IgA and IgG decreased in children with hand-foot-mouth disease,and the levels of serum IgM and cfDNA increased.The positive determination of serum immunoglobulin and cfDNA expression can provide information for clinical diagnosis of hand-foot-mouth disease and assessment of the severity of the disease.