正文 神經內分泌指標對EV71感染手足口病的診斷價值(3 / 3)

正常情況下,機體內多種細胞因子相互發生製約,共同維持機體免疫的平衡;當EV71病毒感染後,機體免疫功能被激活,從而釋放大量細胞因子[12]。細胞因子主要體現在兩個方麵:免疫防護需要細胞因子參與,細胞因子也會刺激免疫損傷。IL-13主要由Th2細胞分泌,促進B細胞活化,介導體液免疫。IFN-γ由Th1細胞分泌,介導機體的細胞免疫反應。本研究A、B、C三組IL-13、IFN-γ水平顯著高於對照組,隨著病情的加重,IL-13、IFN-γ水平逐漸升高,這提示病情跟炎症反應密切相關,兩種因子分別增高,體液免疫和細胞免疫相互拮抗,共同促進了疾病的進展。

綜上所述,EV71感染所致手足口病伴有細胞免疫、體液免疫等免疫功能紊亂,並與疾病進展密切相關;對患兒進行免疫指標和神經內分泌指標監測,有助於評估患兒的病情。

[參考文獻]

[1] Han J,Ma XJ,Xu WB,et al. EV71 viral secretion by symptomatic hand foot and mouth disease patients and their asymptomatic close contacts[J]. J Infect,2011,62(1):107-108.

[2] Jiang B,Zhang J,You X,et al. Diagnosis of hand,foot,and mouth disease caused by EV71 and other enteroviruses by a one-step,single tube,duplex RT-PCR[J]. J Med Virol,2012,84(11):1803-1808.

[3] 田健美,李健琴,孔小行,等. 144例手足口病患兒細胞和體液免疫變化及意義[J]. 臨床兒科雜誌,2011,29(12):1156-1158.

[4] 張偉,王玉光,楊朝暉,等. 腸道病毒71型與柯薩奇A組16型混合感染致手足口病並發中樞神經係統感染臨床分析[J]. 中國全科醫學,2011,14(29):3341-3343, 3346.

[5] Cubillos C,de la Torre BG,Jakab A,et al. Enhanced mucosal immunoglobulin A response and solid protection against foot-and-mouth disease virus challenge induced by a novel dendrimeric peptide[J]. J Virol,2008,82(14):7223-7230.

[6] 武潔,成怡冰,李誌方,等. 腸道病毒71型重症和危重症手足口病患兒腎上腺皮質功能狀態評價[J]. 中華兒科雜誌,2012,50(4):249-254.

[7] Yamaguchi M,Matsuda Y,Sasaki S,et al. Immunosensor with fluid control mechanism for salivary cortisol analysis[J].Biosens Bioelectron,2013,15(41):186-191.

[8] Herath HM,Cabot PJ,Shaw PN,et al. Study of beta endorphin metabolism in inflamed tissue,serum and trypsin solution by liquid chromatography-tandem mass spectrometric analysis[J]. Anal Bioanal Chem,2012,402(6):2089-2100.

[9] 許紅梅,賴方方. 腸道病毒71型對神經係統和免疫功能的影響及疫苗研究進展[J]. 實用兒科臨床雜誌,2012,27(22):1701-1704.

[10] 曾慧慧,顧燕,段雪飛,等. 手足口病患兒外周血T淋巴細胞亞群的臨床研究[J]. 中華傳染病雜誌,2010,28(2):82-85.

[11] 劉亞敏,李穎,任彥,等. 不同病原感染的手足口病患兒外周血T淋巴細胞亞群分析[J]. 中華臨床感染病雜誌,2012,5(3):175-176.

[12] Li J,Chen F,Liu T,et al. MRI findings of neurological complications in hand-foot-mouth disease by enterovirus 71 infection[J]. Int J Neurosci,2012,122(7):338-344.

(收稿日期:2014-11-27)