【摘要】 目的研究肠道病毒71型(EV71)感染的重症手足口患儿外周血中内皮素-1、TNF-α的水平,探讨其变化在EV71感染致重症手足口病的临床意义。方法以EV71感染重症手足口病患儿为研究对象,分别将手足口病2、3、4期的30、30、16例患儿设为研究1、2、3组,同时设手足口病普通对照组(30例)和健康对照组(30名)。收集各研究组患儿急性期、好转期、恢复期以及普通对照组患儿急性期和健康对照组儿童的外周血标本,应用ELISA法检测其血浆中内皮素-1及TNF-α的水平。结果研究1组各时间段血浆中内皮素-1水平变化不明显,与健康对照组比较差异均无统计学意义(P>0.05)。研究2、3组急性期血浆中内皮素-1水平高于健康对照组,并随着病情的加重呈上升趋势(P<0.05)。随着病情好转恢复,研究2、3组血浆中内皮素-1水平逐渐下降至接近正常水平,与急性期比较差异均有统计学意义(P均<0.05)。各研究组急性期血浆中TNF-α水平均高于健康对照组,并随着临床分期的加重呈上升趋势,组间比较差异有统计学意义(P<0.05)。随着病情好转恢复,研究1、2组血浆中TNF-α水平变化不明显(P>0.05);研究3组则逐渐下降至正常水平,与急性期比较差异有统计学意义(P<0.05)。普通对照组急性期血浆中内皮素-1、TNF-α水平与健康对照组比较差异均无统计学意义(P均>0.05)。结论细胞因子内皮素-1、TNF-α可能参与了EV71感染重症手足口病的损害机制,外周血中内皮素-1、TNF-α的变化可在一定程度上反映患儿病情的进展程度及疗效。更多还原

【Abstract】 Objective To assess the plasma levels of endothelin-1( ET-1) and tumor necrosis factor( TNF-α) in peripheral blood of children with severe hand,foot and mouth disease( HFMD) infected with EV71,aiming to explore the clinical significance of these changes in HFMD children infected with EV71.Methods The children who were diagnosed with severe HFMD and EV71 infection hospitalized were enrolled in this study. Thirty children diagnosed with stage II HFMD,30 stage III HFMD and 16 stage IV HFDM were assigned into study groups 1,2 and 3. Thirty HFMD children were allocated into the normal control group and30 into the healthy control group. The blood samples were collected during the acute,remission and recovery stages among all groups. The plasma concentration of ET-1 and TNF-α was detected by using ELISA. Results The changes in the plasma concentration of ET-1 were not significant in study group 1,which did not significantly differ from those in the healthy control group( P > 0. 05). The plasma concentration of ET-1 in study groups 2 and 3 was significantly higher than that in the healthy control group during the acute stage,which increased along with the deterioration of diseases( P < 0. 05). Along with the gradual recovery,the plasma levels of ET-1 in study groups 2 and 3 declined to normal level,significantly differing from that during the acute stage( P < 0. 05). The plasma concentration of TNF-α in all study groups were significantly higher than that in the control group during the acute phase,and tended to elevate along with the worsening of clinical stage with statistical significance( P < 0. 05). Over the period of recovery,the changes in plasma concentration of TNF-αwere not significant in the study groups 1 and 2( P > 0. 05). The level of TNF-α in study group 3 gradually declined to normal level,significantly differing from that during the acute stage( P < 0. 05). The plasma levels of TNF-α and ET-1 did not significantly differ between the normal and healthy control groups. Conclusions TNF-α and ET-1 might be involved with the underlying mechanism of HFMD damages combined with EV71 infection. The changes in the peripheral blood concentration of TNF-α and ET-1 can reflect the development of diseases and evaluation of clinical efficacy.更多还原