【摘要】 目的 分析不同年龄段肠道病毒71型（EV71）感染手足口病患儿外周血CD4~+T细胞、B细胞的表达变化，探讨患儿病情严重程度与机体细胞免疫、体液免疫以及大便排毒量的关系。方法 收集2020年5月至2021年5月昆明市儿童医院感染科确诊的EV71感染手足口病患儿153例。将患儿分为9月～1岁、2～3岁及4～5岁年龄段，各年龄段据病情分为轻症、重症及危重症组。采用流式细胞术检测其外周血中CD4~+T细胞、B细胞，采用实时荧光定量PCR技术检测患儿大便样本病毒载量。结果 不同严重程度手足口患儿外周血CD4~+T细胞均有不同程度的减低，B细胞有不同程度的增高。其中，9月～1岁年龄段患儿，B细胞轻症组与重症组间比较差异有统计学意义（F=42.88,P<0.05）;2～3岁年龄段患儿不同感染程度间CD4~+T细胞、B细胞、大便排毒量比较差异无统计学意义（P>0.05）;4～5岁年龄段患儿，CD4~+T细胞轻症组、重症组间与危重症组间比较差异有统计学意义（F=16.22, P<0.05）。B细胞轻症组与重症组间比较差异有统计学意义（F=14.0 P<0.05）。结论 CD4~+T细胞、B细胞的数量变化以及大便排毒量与EV71感染手足口病患儿病情严重程度分别存在一定关系。推测EV71感染手足口病患儿，机体细胞免疫与体液免疫很可能在不同年龄段分别发挥着不同的抗病毒作用。更多还原

【Abstract】 Objective To analyze the expression levels of CD4~+T cells and B cells in the peripheral blood of children infected with enterovirus 71(EV71) hand-foot-mouth disease across different age groups, and to investigate the relationship between disease severity and cellular immunity, humoral immunity, and stool viral clearance. Methods A total of 153 children diagnosed with EV71-infected hand-foot-mouth disease(HFMD) were recruited from Kunming Children’s Hospital between May 2020 and May 2021. The participants were categorized into three age groups: 9 months to 1 year, 2 to 3 years, and 4 to 5 years. Within each age group, the children were further divided into mild, severe, and critical disease subgroups based on their clinical conditions. Flow cytometry was employed to measure the levels of CD4~+T cells and B cells in peripheral blood, while real-time fluorescence quantitative PCR was used to quantify the viral load in stool samples. Results The levels of CD4~+T cells in the peripheral blood of children with varying degrees of disease severity were found to be decreased, while B cell levels were increased. Notably, there was a statistically significant difference between the mild B cell disease group and the severe B cell disease group(F=42.88, P<0.05). No significant differences were observed in CD4~+T cells, B cells, or stool viral clearance among children aged 2 to 3 years with differing infection severities(P>0.05). In contrast, significant differences in CD4~+T cell levels were noted between the mild, severe, and critical groups among children aged 4 to 5 years(F=16.22, P<0.05). Additionally, a significant difference was observed between the mild B cell disease group and the severe B cell disease group(F=14.0, P<0.05). Conclusion The counts of CD4~+T cells and B cells, as well as the extent of stool viral clearance, are linked to the severity of HFMD in children infected with EV71. It is hypothesized that cellular immunity and humoral immunity could have varying antiviral effects in different age groups of children with HFMD caused by EV71.更多还原