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目的:探讨EV71相关手足口病患儿外周血T细胞及细胞因子的水平及其意义。方法:将90例EV71感染手足口病患儿分为脑炎并发肺水肿组8例,单纯脑炎组30例,无并发症组52例。采用间接免疫荧光法检测外周血CD4+T及CD8+T细胞百分比,用双抗体夹心ABC-ELISA法检测血清IL-6、IL-10、TNF-α及IFN-γ含量。结果:并发症组CD4+及CD8+T淋巴细胞亚群的百分比相对无并发症组的降低,差异有统计学意义(F=9.304,P<0.05;X2=26.075,P<0.05),并发症组血清IL-10、IFN-γ和IL-6含量较无并发症组增高,差异有统计学意义(F=4.232,P<0.05;X2=16.975,P<0.05;X2=15.562,P<0.05),并发症组TNF-α含量和无并发症组差异无统计学意义。结论:外周血T细胞及细胞因子均参与了EV71相关手足口病重症并发症的发生过程,在手足口病的临床诊疗中可予以参考,早期鉴别出现重症并发症的病例,及时给与相应的治疗措施,降低手足口病的病死率和致残率。
Objective: To investigate the levels of T-cells and cytokines in peripheral blood of children with EV71-related hand-foot-mouth disease and its significance. Methods: Ninety children with EV71 infection were divided into 8 cases of encephalitis complicated with pulmonary edema, 30 cases of simple encephalitis and 52 cases of non-complication. The percentage of CD4 + T and CD8 + T cells in peripheral blood was detected by indirect immunofluorescence. The levels of IL-6, IL-10, TNF-α and IFN-γ in serum were detected by double antibody sandwich ABC-ELISA. Results: The percentages of CD4 + and CD8 + T lymphocyte subsets in complication group were significantly lower than those without complication (F = 9.304, P <0.05; X2 = 26.075, P <0.05) The levels of IL-10, IFN-γ and IL-6 in serum were significantly higher than those without complications (F = 4.232, P <0.05; X2 = 16.975, P < There was no significant difference in the level of TNF-α in the complication group and no complication group. CONCLUSION: Peripheral blood T cells and cytokines are involved in the pathogenesis of severe complication of hand-foot-mouth disease associated with EV71. They may be referred to in the clinical diagnosis and treatment of hand-foot-mouth disease. Early identification of severe complication cases and timely Treatment measures to reduce hand-foot-mouth disease mortality and morbidity.