重症手足口病病原学与临床特征、机体免疫状态关系的研究

发布时间：2019-05-22 04:37

【摘要】：目的：探讨重症手足口患儿的病原分类、免疫状态及不同病原的临床特征。方法：以2009年1月-12月济南市传染病医院住院治疗大便核酸检测EV71阳性或Cox A16阳性或仅EV阳性及全阴性组的重症手足口病患儿为研究对象,收集患儿临床特征,当日或次日行流式细胞学检测,检测T细胞(CD3+CD19-)、CD4+T细胞(CD3+CD4+)、CD8+T细胞(CD3+CD8+)、B细胞(CD3-CD19+)和NK细胞(CD3-CD16+CD56+)相对计数,同时行静脉血IgG、IgA、IgM定量检测。根据大便核酸结果分为EV71组、Cox A16组、EV组及病毒检测阴性组,比较临床特征,淋巴细胞亚群水平及IgG、IgA、IgM水平的差异,进行统计分析,找出重症患儿不同病原的临床特征及免疫特点。结果1.重症患儿中,EV71为主要病原体。2.临床特征(年龄、性别、体温、外周血白细胞计数、血糖、肢体抖动)中,肢体抖动四组间有统计学差异,两两比较,EV71组肢体抖动的比例较COXA16组高(p0.05),外周血WBC四组间有统计学差异,两两比较,EV组较EV71组高(p0.05),余各组间无统计学差异。EV71组NK细胞相对计数较COXA16及EV组低(p0.05)。B淋巴细胞相对计数、T淋巴细胞、CD4+T淋巴细胞、CD8+T淋巴细胞相对计数无统计学差异。结论：1.重症患儿中,EV71为主要病原。2.肢体抖动的对提示EV71感染有帮助。3.EV71组较其他各组的NK细胞比例显著下降。意义：1.出现肢体抽动可能比其他指标更能提示EV71感染。2.EV71感染较其他肠道病毒感染NK细胞下降低,NK细胞受损可能参与EV71的疾病发展。
[Abstract]:Objective: to investigate the pathogen classification, immune status and clinical characteristics of children with severe hand, foot and mouth. Methods: from January to December 2009, EV71 positive or Cox A16 positive or only EV positive and all negative children with severe HFMD were detected in the fecal nucleic acid of Jinan Infectious Diseases Hospital, and the clinical features of the children were collected. Flow cytometry was performed on the same day or the next day to detect the relative counts of T cells (CD3 CD19-), CD4 T cells (CD3 CD4), CD8 T cells (CD3 CD8), B cells (CD3-CD19) and NK cells (CD3-CD16 CD56). At the same time, venous blood IgG,IgA, was performed. Quantitative detection of IgM. According to the results of fecal nucleic acid, they were divided into EV71 group, Cox A16 group, EV group and virus negative group. The clinical characteristics, the level of lymphocyte subsets and the level of IgG,IgA,IgM were compared, and the statistical analysis was carried out. The clinical and immune characteristics of different pathogens in severe children were found out. Result 1. EV71 is the main pathogen in severe children. 2. Among the clinical features (age, sex, body temperature, peripheral blood leukocyte count, blood glucose, limb jitter), there were significant differences in limb jitter among the four groups. The proportion of limb jitter in EV71 group was higher than that in COXA16 group (p0.05). There was significant difference in peripheral blood WBC among the four groups. Compared with EV71 group, the relative count of NK cells in EV group was higher than that in EV71 group (p0.05). The relative count of NK cells in EV 71 group was lower than that in COXA16 and EV group (p0.05). There was no significant difference in the relative count of T lymphocytes, CD4 T lymphocytes and CD8 T lymphocytes. Conclusion: 1. EV71 is the main pathogen in severe children. 2. Limb jitter was helpful to suggest EV71 infection. 3. The proportion of NK cells in EV 71 group was significantly lower than that in other groups. Meaning: 1. The presence of limb twitching may be more likely to suggest EV71 infection than other indicators. 2.EV 71 infection is lower than other enterovirus infected NK cells, and NK cell damage may be involved in the disease development of EV71.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.1

【相似文献】