手足口病患儿淋巴细胞亚群和免疫球蛋白及补体C3、C4水平分析

目的 分析淋巴细胞亚群、免疫球蛋白及补体C3、C4在手足口病患儿免疫状态评估中的临床应用价值。方法 选取282例手足口病患儿为手足口病组，130例健康儿童为健康对照组；检测两组外周血CD3⁺、CD4⁺、CD8⁺T淋巴细胞、CD19+B淋巴细胞、CD56+自然杀伤细胞比例，CD4⁺/CD8⁺、IgA、IgM、IgG和补体C3、C4水平。结果 多因素分析显示，手足口病组CD3⁺、CD4⁺、CD8⁺T淋巴细胞比例及补体C3、C4水平低于健康对照组（P < 0.05），CD56+自然杀伤细胞比例、IgG水平高于健康对照组（P < 0.05）。单独效应分析显示，0岁~手足口病组CD4⁺/CD8⁺高于健康对照组（P < 0.05）；0岁~及3岁~的男性手足口病组IgM水平高于健康对照组（P < 0.05）；3岁~男性及0岁~女性手足口病组IgA水平低于健康对照组（P < 0.05）。结论 手足口病患儿存在细胞免疫及体液免疫功能紊乱，监测淋巴细胞亚群、免疫球蛋白水平可以为手足口病患儿的免疫状态评估提供实验室依据。

Levels of lymphocyte subsets, immunoglobulins, and complement C3 and C4 in children with hand-foot-mouth disease

Objective To study the clinical value of lymphocyte subsets, immunoglobulins, and complement C3 and C4 in the evaluation of immune status in children with hand-foot-mouth disease (HFMD). Methods A total of 282 children with HFMD were enrolled as the HFMD group, and 130 healthy children were enrolled as the healthy control group. The percentages of peripheral CD3+, CD4+, and CD8+ T lymphocytes, CD19+ B lymphocytes, and CD56+ natural killer cells were measured. The CD4+/CD8+ ratio was calculated. The levels of immunoglobulin A (IgA), immunoglobulin M (IgM), immunoglobulin G (IgG), and complement C3 and C4 were measured. Results The multivariate analysis showed that compared with the healthy control group, the HFMD group had significantly lower percentages of CD3+, CD4+, and CD8+ T lymphocytes and levels of complement C3 and C4 (P < 0.05), as well as significantly higher percentage of CD56+ natural killer cells and level of IgG (P < 0.05). The individual effect analysis showed that the children aged 0-3 years in the HFMD group had a significantly higher CD4+/CD8+ ratio than the healthy control group (P < 0.05); boys aged 0-3 and ≥ 3 years in the HFMD group had a significantly higher level of IgM than the healthy control group (P < 0.05); boys aged ≥ 3 years and girls aged 0-3 years in the HFMD group had a significantly lower level of IgA than the healthy control group (P < 0.05). Conclusions Cellular and humoral immunity disorders are observed in children with HFMD. The monitoring of lymphocyte subsets and immunoglobulin levels can provide a laboratory basis for immune status assessment in children with HFMD.