肠道病毒71 与肺炎支原体二重感染对 手足口病患儿免疫功能的影响

Effect of double infection of EV71 virus and mycoplasma pneumoniae on immunity of children with hand foot mouth disease

摘要:

目的 探讨肠道病毒71（EV71）与肺炎支原体（MP）二重感染对手足口病患儿细胞免疫和体液 免疫的影响。方法 选取该院PICU 重症手足口病患儿120 例为研究对象，根据是否感染EV71 和MP，将研 究对象分为甲组31 例、乙组34 例、丙组28 例、丁组27 例，选取同期30 例健康患儿为对照组，比较各组血 CD3+、CD4+、CD8+、CD4+/CD8+ 比值、白介素6（IL-6）、白介素10（IL-10）、IgA、IgG、IgM 的不同表达水平， 比较4 组手足口病重症危重型发病率。结果 ① 4 组手足口病与对照组比较，差异有统计学意义（P <0.05）， 血CD3+、CD4+ 及CD4+/CD8+ 比值、IgA、IgG、IgM 低于对照组，CD8+、IL-6、IL-10 高于对照组；② 4 组手 足口病比较，差异有统计学意义（P <0.05），血CD3+、CD4+ 及CD4+/CD8+ 比值、IgA、IgG、IgM 水平，丁组至 甲组依次降低，CD8+、IL-6、IL-10，丁组至甲组依次升高；③各组手足口病重症危重型发病率差异有统计 学意义（P <0.001），甲组至丁组重症危重型发病率依次降低。结论 EV71 病毒与肺炎支原体二重感染致手足 口病患儿细胞免疫及体液免疫均降低。

Abstract:

Objective To investigate the effects of EV71 virus and mycoplasma pneumoniae infection on cell immunity and humoral immunity in children with hand foot and mouth disease. Method Totally 120 cases with severe hand foot and mouth disease (HFMD) in PICU in our hospital were involved. The subjects were divided into group 1 (n = 31), group 2 (n = 34), group 3 (n = 28) and group 4 (n = 27). Thirty healthy children were enrolled incontrol group. Levels of CD3+, CD4+, CD8+, CD4+ /CD8+ ratio, IL-6, IL-10, IgA, IgG and IgM were determined. Result Compared with control group, all 4 groups experienced decreased levels of CD3+, CD4+, CD4+ /CD8+, IgA, IgG and IgM and increased levels of CD8+, IL-6 and IL-10 (P < 0.05). Among 4 groups, The difference was statistically significant by t test (P < 0.05). The blood concentration of CD3+, CD4+, CD4+ /CD8+ ratio, IgA, IgG and IgM was highest in group 4 and lowest in group 1, while levels of CD8+, IL-6 and IL-10 were highest in group 1 and lowest in group 4. Incidence of severe HFMD was statistically different among 4 groups with group 1 as the highest and group 4 as the lowest (P = 0.000). Conclusion Cell immunity and humoral immunity of children with HFMD are compromised significantly by the double infection of EV71 and Mycoplasma pneumoniae.