肠道病毒71型感染手足口病患儿血清Th17Treg细胞表达与病情程度相关性及预后评估

目的探讨Th17和Treg细胞在肠道病毒71型感染手足口病(HFMD)患儿血清中的表达,并分析其与病情严重程度的相关性。方法选取2018年1月至2020年3月肠道病毒71型感染HFMD患儿80例,其中轻症组42例,重症组38例。30例同期体检健康患儿为对照组。检测3组患几外周血Th17和Treg细胞的表达并分析其与病情严重程度的相关性。根据随访结果将所有患儿分为预后良好组(n=76)和预后不良组(n=4),分析两组间Th17和Treg细胞的表达。结果与对照组比较,轻症组和重症组患儿血清Th17细胞百分比显著增加(P<0.05),重症组高于轻症组(P<0.05)。与对照组比较,轻症组和重症组患儿血清Treg细胞百分比降低(P<0.05),重症组低于轻症组(P<0.05)。Th17细胞百分比与病情严重程度呈正相关(Rs=0.489,P=0.009),Treg细胞百分比与病情严重程度呈负相关(Rs=-0.307,P=0.031)。预后良好组患儿血清Th17细胞百分比低于预后不良组(P<0.05),而Treg细胞百分比高于预后不良组(P<0.05)。结论HFMD患儿血清Th17细胞表达增加,并与病情严重程度正相关,与预后良好负相关。而Treg细胞在HFMD患儿血清中低表达,与病情严重程度负相关,与预后良好正相关。

The correlation and prognosis evaluation of serum Th17 Treg expression and severity of hand foot mouth disease in children with enterovirus 71 infection

Objective To explore the expression of T helper 17(Th17)cells and regulatory T(Treg)cells in the serum of children with different degrees of disease and different prognosis of hand-foot-mouth disease(HFMD)infected by Enterovirus 71,and analyze its correlation with disease severity.Methods 80 children with HFMD infected by Enterovirus 71 and diagnosed from January 2018 to March 2020 were selected,including 42 in the mild group and 38 in the severe group,and 30 children underwent physical examination at same period wrere taken as control group.The expression of Th17 and Treg cells in peripheral blood of children in the 3 groups was detected and the correlation with disease severity of HFMD children was analyzed.According to the results of the follow-up,all 80 cases were divided into a group with good prognosis(n=76)and a group with poor prognosis(n=4),and the expression of Th17 and Treg cells was analyzed.Results Compared with the control group,the percentage of serum Th17 cells in the mild group and the severe group was significantly increased(P<0.05),and the severe group was higher than the mild group(P<0.05).Compared with the control group,the percentage of serum Treg cells in the mild group and the severe group was significantly reduced(P<0.05),and the severe group was lower than the mild group(P<0.05).Spearman rank correlation analysis showed that Th17 cell percentage was positively correlated with disease severity(Rs=0.489,P=0.009),and Treg cell percentage was negatively correlated with disease severity(Rs=-0.307,P=0.031).The percentage of Th17 cells in the serum of the children with good progiosis was significantly lower than that of the group with poor prognosis(P<0.05),while the percentage of Treg cells was significantly higher than that of the group with poor prognosis(P<0.05).Conclusion The increased expression of Th17 cells in serum of HFMD children is positively correlated with disease severity and negatively correlated with good prognosis.The low expression of Treg cells in the serum of HFMD children is negatively correlated with disease severity and positively correlated with good prognosis.