不同年龄段儿童手足口病免疫细胞变化特点的研究

目的 分析不同年龄段儿童手足口病免疫细胞变化的特点,以期为儿童手足口病的预防诊治提供指导。方法 2015年1月-2018年1月收集1 090例不同年龄段手足口病(HMFD)患儿EDTA抗凝外周血,经破红、洗涤处理后分别加入CD3、CD4、CD8、CD19及CD16/CD56 5种荧光单抗对细胞进行标记,流式细胞仪对CD3+、CD4+、CD8+、CD19+及CD16+/CD56+五种免疫细胞含量进行分析。将患儿分为0~6个月、6个月＜~5岁、5＜~12岁3组,使用SPSS 19.0软件对3组患儿5种细胞含量构成比和升降幅度分别进行比较。结果 6个月<~5岁组患儿占总例数的89.1%,为HFMD高发组;该年龄段患儿CD3+(χ²=9.824,P=0.007)、CD4+(χ²=16.367, P＜0.001)及NK(χ²=8.666,P=0.013)细胞含量降低的比例, CD19+细胞(χ²=13.867,P=0.001)含量增高的比例与其他年龄组患儿比较,差异均有统计学意义;另外,该年龄段患儿CD3+细胞(F=3.907,P=0.020)含量降低的幅度,CD19+细胞(F=9.952,P＜0.001)含量升高的幅度较其他年龄组患儿比较,差异有统计学意义。结论 6个月<~5岁是HFMD的高发年龄段,该年龄段患儿免疫细胞的变化更为明显。细胞免疫功能指标的下降伴随CD19+细胞含量增高提示患儿病情急变,临床宜加强该年龄段患儿的免疫功能监控,调节免疫平衡,及早预防,从而改善患儿预后。

Study on the immunocyte variation feature of children with hand-foot-and-mouth disease in different age groups

Objective To disclose the immunocytes variation feature of children with hand-foot-and-mouth disease (HFMD) in different age groups, in order to provide guidance for the prevention and treatment of HFMD. Methods Totally 1 090 HFMD children were enrolled in this study from January 2015 to January 2018, and their EDTA anticoagulation peripheral blood samples were collected. Fluorescence labeling monoclonal antibodies against CD3, CD4, CD8, CD19 and CD16/CD56 were separately used to mark WBCs after erythrocytolysis and purification. Flow cytometry was employed to analyze the immunocyte content. Children were divided into three groups, including 0~6 months, 6 months＜-5 years old and 5＜-12 years old. The constituent ratio and variations of content of CD3, CD4, CD8, CD19 and CD16/CD56 among different age groups were analyzed and compared by SPSS 19.0. Results HFMD was prevalent in children aged 6 months to 5 years (89.1%). There were significant differences on the constituent ratio of the decrease of CD3+(χ²=9.824,P=0.007), CD4+(χ²=16.367, P＜0.001), NK(χ²=8.666,P=0.013) and constituent ratio of the increase of CD19+(χ²=13.867,P=0.001) cells between children aged 6 months to 5 years and other groups. Besides, the decrease level of CD3+ cells(F=3.907,P=0.020) and the increase level of CD19+ cells(F=9.952,P＜0.001)were significantly different between children aged 6 months to 5 years and other groups. Conclusions HFMD is prevalent in children aged 6 months to 5 years, and the immunocyte variation is more obvious in this age group. Deficiency of cellular immunity accompanied with increase of CD19+ cells indicates the acute transformation of the disease. So more attention should be paid to immunologic monitoring and balance regulation, thereby improving prophylaxis and prognosis of these patients.