676例手足口病患儿T淋巴细胞亚群的临床分析

目的 总结手足口病(HFMD)患儿T淋巴细胞亚群的变化趋势,为临床治疗及预后评估提供依据.方法 采用流式细胞仪检测2009年3月1日至2011年12月31日,在南宁市第四人民医院住院的676例手足口病患儿急性期的T淋巴细胞亚群；对其中106例重症及危重症患儿咽拭子和肛试子标本进行RT-PCR以确定病原.对不同样本行独立样本,t检验、配对t检验或方差分析.结果 570例普通病例患儿中555例的急性期T淋巴细胞亚群均数与同龄婴幼儿及儿童正常参考水平一致,仅有15例低于正常均数；106例重症及危重症患儿T淋巴细胞亚群计数较普通病例患儿明显降低,差异有统计学意义.结论 HFMD患儿细胞免疫功能普通组与正常儿童比较没有明显变化,而重症和危重症组明显降低,细胞免疫功能状况可作为判断病情和预后的重要指标,同时对重症及危重症病例临床治疗具有重要指导意义.

Changes of T-lymphocyte subsets in 676 children with Hand-foot-mouth Disease

Objective To investigate the changing trend of T-lymphocyte subsets in children with hand-foot-mouth disease（HFMD）.Methods Levels of T-lymphocyte subsets were determined in 676 hospitalized HFMD children by flow cytometry in Nanning No.4 Hospital from March 1,2009 to December 31,2011.RT-PCR was used to detect pathogen in nasopharyngeal or anus swabs from 106 severe child cases and critically ill children,.The results were statistically analyzed.Results Among 570 HFMD children with common diseases,the mean T-lymphocyte subsets in 555 children at acute phase showed the same level as contemporary infants and children in normal range（Table 1）;only 15 cases were lower than normal means.The counts of T-lymphocyte subsets in 106 severe and critically ill children were obviously lower than those with common diseases,which was statistically significant.Conclusion Immune system in common group for children with HFMD showed no significant changes compared to normal children,while the severe and critically ill group（with 96% EV71 positive） showed obviously lower level,thus cellularimmune function could be a critical index of determining illness state and prognosis,meanwhile it is of significant for guidance of treatment of severe and critically ill cases.