免疫功能狀態(tài)與手足口病發(fā)病及病情程度之間的關(guān)系
發(fā)布時間：2018-10-29 19:21
【摘要】：目的:探究免疫功能狀態(tài)與手足口病發(fā)病及病情程度之間的關(guān)系,為手足口病的診斷與治療提供依據(jù)。方法:選取2016年9月~2016年12月期間于本院進行診治的137例手足口病患兒為觀察組,根據(jù)手足口病診療指南(2010年版),將觀察組又分為輕癥組119例、重癥組18例,同時將同時期的60名同齡健康兒童入選為對照組,然后采集兩組患兒的外周靜脈血進行免疫狀態(tài)相關(guān)指標的檢測,檢測T(CD3+)、Th(CD4+)、Ts(CD8+)、CD4+/CD8+、B(CD19+)、NK(CD16+56+)的相對計數(shù),同時行靜脈血IgA、Ig M及IgG定量檢測。將兩組兒童的上述免疫指標進行比較,并比較手足口病嚴重程度(輕癥及重癥)及感染類型(EV71陽性組與陰性組)的檢測結(jié)果,進行統(tǒng)計分析探究上述免疫指標與手足口病的關(guān)系。結(jié)果:重癥組、輕癥組CD3+、CD4+均較對照組低,組間比較差異有統(tǒng)計學意義(均P0.05);重癥組患兒的CD3+、CD4+均較輕癥組低,兩組比較差異有統(tǒng)計學意義(均P0.05);重癥組和輕癥組的CD19+均較對照組高,組間比較差異有統(tǒng)計學意義(均P0.05),重癥組CD19+高于輕癥組,兩組比較差異有統(tǒng)計學意義(P0.05);但CD8+、CD4+/CD8+、CD16+56+兩組間比較,差異無統(tǒng)計學意義(均P0.05)。重癥組、輕癥組IgG均明顯高于對照組,組間比較差異有統(tǒng)計學意義(均P0.05),IgA、IgM差異無統(tǒng)計學意義(均P0.05);IgA、IgG、IgM水平在觀察組中輕癥、重癥組之間比較,差異均無統(tǒng)計學意義(均P0.05)。EV71陽性組患兒CD4+明顯低于EV71陰性組,兩組比較差異有統(tǒng)計學意義(P0.05)。EV71陽性組的IgA、IgG、IgM值比EV71陰性組明顯增高,兩組比較差異有統(tǒng)計學意義(均P0.05)。結(jié)論:1、手足口病患兒存在體液免疫及細胞免疫異常情況,并與患兒的病情相關(guān),對相關(guān)指標的檢測有利于提高臨床預后評估的質(zhì)量。2、EV71感染較其他病毒感染細胞免疫、體液免疫紊亂更嚴重,提示細胞免疫、體液免疫紊亂可能參與EV71感染疾病的發(fā)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.
【學位授予單位】：南昌大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R725.1
本文編號：2298576
[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.
【學位授予單位】：南昌大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R725.1
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