【摘要】 目的探讨三种不同手足口病病毒分型与免疫功能的关系及分析药物干预效果。方法选取2014年7月至2016年4月在揭阳市人民医院住院的172例手足口病患儿作为研究对象,将其按照病毒分型分为EV71型组、CoxA 16型组及普通型组,分析不同病毒分型患儿T淋巴细胞亚群因子、免疫球蛋白及补体变化、热毒宁联合利巴韦林治疗后上述指标的变化。结果 EV71型组、普通型组的3A期患儿CD3~+和CD4~+显著低于1期、2期患儿(t=5.05~9.03,均P<0.05),而3A期患儿的CD8~+显著高于1期、2期患儿(t=4.89~8.87,均P<0.05);CoxA 16型组显效率显著高于EV71型组、普通型组(χ~2值分别为5.32、6.36,均P<0.05),三组的总有效率差异无统计学意义(P>0.05);治疗5天后,EV71型组CD3~+、CD4~+/CD8~+显著低于CoxA 16型组、普通型组(t=4.82~6.02,均P<0.05),而IgM显著高于CoxA 16型组、普通型组(t=6.91~10.04,均P<0.05);治疗5天后,CoxA 16型组IgA显著高于EV71型组、普通型组(t=4.88~5.29,均P<0.05),而CD8~+显著低于EV71型组、普通型组(t=5.81~7.71,均P<0.05);各组患者在不良反应发生率方面,差异无统计学意义(χ~2=1.07,P>0.05)。结论 EV71型手足口病患儿免疫功能紊乱更为严重,采用热毒宁联合利巴韦林治疗后,CoxA 16型病毒患儿免疫功能恢复更快。更多还原

【Abstract】 Objective To investigate the relationship between three kinds of hand-foot-mouth disease( HFMD) virus and immune function and the effect of drug intervention. Methods Totally 172 children patients with HFMD were divided into enterovirus type 71( EV71)group,Coxsackie virus A16( CoxA 16) group and common group according to virus type. Analysis was made on the changes of T lymphocyte subsets,immunoglobulin and complement in cases with different virus type and the changes of these indexes after treatment with Roxynine combined with ribavirin. Results CD3~+and CD4~+of cases at 3A stage in EV71 group and common group were significantly lower than those at 1 and 2 stage( t value ranged 5. 05-9. 03,all P < 0. 05),but CD8~+was significantly higher than that at 1 and 2 stage( t value ranged 4. 89-8. 87,all P < 0. 05). Significant efficiency of CoxA 16 group was significantly higher than that of EV71 group and common group( χ~2 value was 5. 32 and 6. 36,respectively,both P < 0. 05). There was no significant difference in total effective rate among three groups( P > 0. 05). After 5-day treatment,CD3~+and CD4~+/CD8~+in EV71 group were significantly lower than those in CoxA16 group and common group( t value ranged 4. 82-6. 02,all P < 0. 05),while IgM was significantly higher than that in CoxA 16 group and common group( t value ranged 6. 91-10. 04,P < 0. 05). IgA in CoxA 16 group was significantly higher than in EV71 group and common group( t value ranged 4. 88-5. 29,all P < 0. 05),but CD8~+was significantly lower than in EV71 group and common group( t value ranged 5. 81-7. 71,all P < 0. 05). There was no significant difference in the incidence of adverse reactions among different groups( χ~2 = 1. 07,P > 0. 05). Conclusion Immune dysfunction of children with EV71 type of HFMD is more severe. After treatment with Roxynine combined with ribavirin,immune function of children with CoxA 16 virus restores faster.更多还原