CAJ | 학술논문

目的探讨手足口病患儿细胞免疫功能与病情严重程度的关系及随病情恢复的变化.方法收集560例手足口病患儿临床资料,按有无合并脑炎分为2组,重症病例组(脑炎组)360例,普通病例组(无脑炎组)200例,并选取同期本院儿保科进行体检的健康儿童120例为正常对照组,对照组在体检时,病例组分别于入院2h内(急性期)、治疗1周后(恢复期)进行T细胞亚群(CD3+,CD4+,CD8+)百分率及血清IgG、IgA、IgM水平检测,分析各组细胞免疫水平的差异,比较重症病例组和普通病例组急性期及恢复期的细胞免疫改善程度.结果 560例手足口病患儿中普通病例组CoxA16阳性率(72.0％)高于重症组(5.0％,x2=280.72,P＜0.01),而重症病例组EV71 (70.3％)及其它病毒阳性率(7.2％)高于普通病例组(20.5％,x2=127.75,P＜0.01;2.5％,x2=5.43,P ＜0.05);普通病例组、重症病例组的细胞免疫与正常对照组比较差异有统计学意义(t=9.82,4.98,3.06,P＜0.01);普通病例组、重症病例组入院2h内与1周后(恢复期)复查CD3+,CD4+,CD8+,比较差异有统计学意义(普通病例组t=7.73,3.86,4.71,P＜0.01,重症病例组t=6.13,2.60,3.36,P＜0.01);普通病例组与重症病例组比较,普通病例组1周前后细胞免疫改善更明显(t=2.57,2.51,2.95),差异均有统计学意义(P＜0.05).结论手足口病患儿未合并脑炎者病原学检测以CoxA16阳性率高,合并脑炎者EV71及其它病毒阳性率高;两组患儿病初细胞免疫功能降低,治疗1周后细胞免疫功能均明显恢复,且与临床症状轻重有关.
목적 탐토수족구병환인세포면역공능여병정엄중정도적관계급수병정회복적변화.방법 수집560례수족구병환인림상자료,안유무합병뇌염분위2조,중증병례조(뇌염조)360례,보통병례조(무뇌염조)200례,병선취동기본원인보과진행체검적건강인동120례위정상대조조,대조조재체검시,병례조분별우입원2h내(급성기)、치료1주후(회복기)진행T세포아군(CD3+,CD4+,CD8+)백분솔급혈청IgG、IgA、IgM수평검측,분석각조세포면역수평적차이,비교중증병례조화보통병례조급성기급회복기적세포면역개선정도.결과 560례수족구병환인중보통병례조CoxA16양성솔(72.0％)고우중증조(5.0％,x2=280.72,P＜0.01),이중증병례조EV71 (70.3％)급기타병독양성솔(7.2％)고우보통병례조(20.5％,x2=127.75,P＜0.01;2.5％,x2=5.43,P ＜0.05);보통병례조、중증병례조적세포면역여정상대조조비교차이유통계학의의(t=9.82,4.98,3.06,P＜0.01);보통병례조、중증병례조입원2h내여1주후(회복기)복사CD3+,CD4+,CD8+,비교차이유통계학의의(보통병례조t=7.73,3.86,4.71,P＜0.01,중증병례조t=6.13,2.60,3.36,P＜0.01);보통병례조여중증병례조비교,보통병례조1주전후세포면역개선경명현(t=2.57,2.51,2.95),차이균유통계학의의(P＜0.05).결론 수족구병환인미합병뇌염자병원학검측이CoxA16양성솔고,합병뇌염자EV71급기타병독양성솔고;량조환인병초세포면역공능강저,치료1주후세포면역공능균명현회복,차여림상증상경중유관.
Objective To investigate the relationship of cellular immunity of the hand-foot-mouth disease (HFMD) children and the disease severity and the variation following the recovery of disease.Methods A total of 560 HFMD cases was collected,and divided into severe and common groups.Another 120 cases were collected for comparison.T cell subsets (CD3 +,CD4 +,and CD8 +) rates were tested.The difference in cell immunity in each group were compared,and the comparison of cell immunity improv-ment during acute and recovery periods was conducted at the same time.Results In the 560 cases of children with HFMD,CoxA16-positive rate in common group was higher than that in severe group (x2 =280.72,P ＜0.01,severe cases); EV71 and other virus positive rates in severe group were higher than that in common group (x2 =127.75,P ＜ 0.01,x2 =5.43,P ＜ 0.05).Cell immunity was compared among3 groups (t =9.82,4.98,3.06); CD3+,CD4+,CD8+ results,tested within 2h after admission and after 1 week,were compared between severe and common groups (common group t =7.73,3.86,4.71; severe group t =6.13,2.60,3.36).Compared to severe group,cell immunity improvement was more obvious between before and after 1-week treatment in common group (t =2.57,2.51,2.95).The difference was statistically significant (P ＜ 0.05).Conclusions According to the etiology test of children with HFMD,CoxA16-positive rate was higher in common group; EV71 and other virus positive rates were higher in severe group.Cell immunity function decreased in severe and common group at the beginning of the disease; it was,however,significantly restored after 1-week treatment; and it was related to the severity of clinical symptoms.