重症手足口病细胞因子水平与免疫球蛋白的应用研究

目的：探析感染EV71重症手足口病细胞因子水平与免疫球蛋白的应用研究。方法回顾性调查我院2012年1-12月EV71感染的手足口病神经系统受累期患者104例，分为两组，每组52例，A组于入院当天及次日予以静脉内注射免疫球蛋白（IVIG）1g/kg治疗；B组未予IVIG疗法，另选择18例健康同龄儿童作为正常对照组，应用ELISA法检测所有研究对象的IL-6、IL-10、TNF-α、TGF-β血清浓度，比较EV71感染手足口病患儿IVIG治疗前后的细胞因子水平变化。结果重症手足口病患儿应用IVIG后血清IL-6、IL-10、TNF-α明显下降，结果具有统计学意义（ P＜0．05），而TGF-β没有显著差异。应用IVIG可缩短住院时间（P＜0．05），但是治愈率、死亡率没有显著差异。结论重症EV71感染手足口病患儿免疫功能变化复杂，应用IVIG可调节细胞因子水平，从而达到抗炎症反应和调节免疫功能的作用，缩短住院时间。

Cytokines levels in severe hand-foot-mouth disease patients and the application of immunoglobulin

Objective Analyze the levels of cytokines in patients who infected severe-hand-foot mouth disease and the application of immunoglobulin .Methods Retrospectively investigated the datas of 104 cases of patients who were suffered from hand-foot-mouth disease and got therapy in our hospital during January 2012 and December 2012, they were divided into two groups , 52 cases in each group.Patients in group A were treated with immunoglobulin （ IVIG） 1g/kg through intravenous access on admission day and the next day , and the treatment for patients in group B without IVIG , another 18 cases healthy children served as normal control group .ELISA assay was applied to detect the concentration of cytokines （IL-6, IL-10, TNF-α, TGF-β） in serum, cytokine levels in children with hand-foot-mouth disease were compared .Results Concentration of IL-6, IL-10, TNF-αin serum of HFMD patients decreased significantly after the application of IVIG （P〈0.05）, but the level of TGF-βdidn＇t change.Application of IVIG can shorten the time of hospitalization （P〈0.05）, but cure rate and mortality rate showed no significant change .Conclusions The changes of immune function in children with hand foot and mouth disease were complex , and the application of IVIG can regulate levels of cell factor and achieve the purpose of anti-inflammatory reaction and regulating immune function ,shorten the time of hospitalization .