免疫功能状态与手足口病发病及病情程度之间的关系

发布时间：2018-10-29 19:21

【摘要】：目的:探究免疫功能状态与手足口病发病及病情程度之间的关系,为手足口病的诊断与治疗提供依据。方法:选取2016年9月~2016年12月期间于本院进行诊治的137例手足口病患儿为观察组,根据手足口病诊疗指南(2010年版),将观察组又分为轻症组119例、重症组18例,同时将同时期的60名同龄健康儿童入选为对照组,然后采集两组患儿的外周静脉血进行免疫状态相关指标的检测,检测T(CD3+)、Th(CD4+)、Ts(CD8+)、CD4+/CD8+、B(CD19+)、NK(CD16+56+)的相对计数,同时行静脉血IgA、Ig M及IgG定量检测。将两组儿童的上述免疫指标进行比较,并比较手足口病严重程度(轻症及重症)及感染类型(EV71阳性组与阴性组)的检测结果,进行统计分析探究上述免疫指标与手足口病的关系。结果:重症组、轻症组CD3+、CD4+均较对照组低,组间比较差异有统计学意义(均P0.05);重症组患儿的CD3+、CD4+均较轻症组低,两组比较差异有统计学意义(均P0.05);重症组和轻症组的CD19+均较对照组高,组间比较差异有统计学意义(均P0.05),重症组CD19+高于轻症组,两组比较差异有统计学意义(P0.05);但CD8+、CD4+/CD8+、CD16+56+两组间比较,差异无统计学意义(均P0.05)。重症组、轻症组IgG均明显高于对照组,组间比较差异有统计学意义(均P0.05),IgA、IgM差异无统计学意义(均P0.05);IgA、IgG、IgM水平在观察组中轻症、重症组之间比较,差异均无统计学意义(均P0.05)。EV71阳性组患儿CD4+明显低于EV71阴性组,两组比较差异有统计学意义(P0.05)。EV71阳性组的IgA、IgG、IgM值比EV71阴性组明显增高,两组比较差异有统计学意义(均P0.05)。结论:1、手足口病患儿存在体液免疫及细胞免疫异常情况,并与患儿的病情相关,对相关指标的检测有利于提高临床预后评估的质量。2、EV71感染较其他病毒感染细胞免疫、体液免疫紊乱更严重,提示细胞免疫、体液免疫紊乱可能参与EV71感染疾病的发展。
[Abstract]:Objective: to explore the relationship between immune function and the incidence and severity of hand, foot and mouth disease (HFMD) in order to provide evidence for diagnosis and treatment of HFMD. Methods: 137 children with HFMD treated in our hospital from September 2016 to December 2016 were selected as the observation group. According to the guidelines for diagnosis and treatment of HFMD (2010 edition), the observation group was divided into two groups: 119 cases of mild disease group and 18 cases of severe group. At the same time, 60 healthy children of the same age were selected as control group. The peripheral venous blood of the two groups were collected for the detection of immune state, T (CD3), Th (CD4), Ts (CD8), CD4 / CD8, B (CD19. The relative count of NK (CD16 56) and quantitative detection of IgA,Ig M and IgG in venous blood were also performed. The above immunological indexes were compared between the two groups, and the severity of hand, foot and mouth disease (mild and severe) and the type of infection (EV71 positive group and negative group) were compared. Statistical analysis was carried out to explore the relationship between the above immune indexes and hand, foot and mouth disease (HFMD). Results: the CD3 and CD4 of severe group and mild group were lower than that of control group (P0.05), the CD3 and CD4 of severe group were lower than that of mild group (P0.05). The CD19 of severe group and mild group were higher than that of control group (P0.05). The CD19 of severe group was higher than that of mild group (P0.05). However, there was no significant difference between CD8, CD4 / CD8 and CD16 56 groups (P0.05). The IgG of severe group and mild group were significantly higher than that of control group (P0.05), but the difference of IgA,IgM was not significant (P0.05). There was no significant difference in the level of IgA,IgG,IgM between mild and severe groups (P0.05). The level of CD4 in EV71 positive group was significantly lower than that in EV71 negative group. There was significant difference between the two groups (P0.05). The IgA,IgG,IgM value of EV71 positive group was significantly higher than that of EV71 negative group, and the difference between the two groups was statistically significant (P0.05). Conclusion: 1. Abnormal humoral immunity and cellular immunity exist in children with HFMD, and they are related to the condition of children. The detection of relative indexes is helpful to improve the quality of clinical prognostic evaluation. 2 the infection of EV71 is more effective than that of other viruses in cellular immunity. Humoral immune disorder is more serious, suggesting that cellular immunity and humoral immune disorder may be involved in the development of EV71 infection.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R725.1

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