EV71感染手足口病不同程度患儿T细胞亚群、免疫球蛋白水平变化探讨

目的探析感染EV71重症手足口病细胞因子水平与免疫球蛋白水平的变化。方法入选我院2012年1月至2013年11月EV71感染的手足口神经系统受累期患儿104例，按病情严重程度分入A组（重症急性期患儿）、B组（普通组），每组52例，应用ELISA法检测所有研究对象的IL-6、IL-10、TNF—α／、TGF-β血清浓度，比较两组患儿的免疫球蛋白水平、T细胞亚群水平变化。结果A组的IgA、IgG、IgM等指标水平显著高于B组（P＜O．05）；A组重症手足口病患儿的T细胞亚群CD3＋、CD4＋、CD4＋／CD8＋水平显著低于B组，差异具有统计学意义（P＜0．05）。结论重症手足口病患儿血清免疫球蛋白指标呈高浓度状态，T细胞亚群指标呈现低浓度状态。结合患儿的临床表现．更准确地早期识别重症病例。

Research on the Changes of T Cell Subsets and Immunoglobulin in Children with Different Degree EV71 Infection of Hand- Foot-and-Mouth Disease

Objective To study the levels of cytokines and immunoglobulin in children with severe EV71 infection of hand-foot-andmouth disease （HFMD）. Methods 104 cases of EV71 infected HFMD with nervous system involvement in our hospital from January 2012 to November 2013 were divided into group A （children at severe acute period） and group B （normal group） according to the severity of the disease, with 52 cases in each group. ELISA assay was applied to detect IL-6, IL-10,TNF-α, TGF-β concentrations of all the subjects, and the levels of serum immunoglobulin, changes of T cell subsets in two groups were compared. Results The levels of IgA, IgG and IgM of group A were significantly higher than those in group B （P 〈0.05）. The levels of CD3＋, CD4＋, CD4＋/CD8＋ of T cell subsets in group A were significantly lower than those in group B （P〈0.05）. Conclusions Children with severe HFMD show high concentrations of immunoglobulin indices, and low concentrations of T cell subsets. Clinical manifestations can help to diagnose server cases.