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目的检测Cox A16感染手足口病患儿血清免疫球蛋白、外周血T细胞亚群的变化,探讨Cox A16引起手足口病的致病机制。方法采用实时荧光PCR检测2013年5月-2014年5月咽拭子标本为Cox A16阳性患儿78例。按疾病严重程度分为重症病例组和普通病例组,另选40例健康体检儿童为健康对照组。采用免疫比浊法检测血清Ig M、Ig A、Ig G;流式细胞仪测定T细胞亚群,对检测结果进行比较。结果重症病例组患儿血清Ig M、Ig A较普通病例组和健康对照组减少,差异有统计学意义(tIg M=3.614、4.127;tIg A=3.152、3.873,P<0.05),普通病例组Ig G含量高于重症病例组和健康对照组,差异有统计学意义(tIg G=2.951、3.236,P<0.05);与普通病例组和健康正常对照组比较,重症病例组T细胞亚群CD3+、CD4+、CD4+/CD8+比例降低,CD8+比例升高,差异有统计学意义(tCD3+=3.314、4.247;tCD4+=3.124、4.043;tCD4+/CD8+=3.251、3.867;tCD8+=3.326、3.915,P<0.05)。结论 Cox A16病毒感染后,患儿机体体液免疫受抑制,细胞免疫功能降低,可能与其致病机制有关。
Objective To detect the changes of serum immunoglobulin and T lymphocyte subsets in Cox A16 infected children with hand-foot-mouth disease and to explore the pathogenesis of Cox A16-induced hand-foot-mouth disease. Methods Real-time fluorescence PCR was used to detect throat swab samples from May 2013 to May 2014 in 78 Cox A16 positive children. According to the severity of the disease can be divided into severe case group and common case group, another 40 healthy children were selected as healthy control group. Serum Ig M, Ig A and Ig G were detected by immunoturbidimetry. T cell subsets were determined by flow cytometry and the results were compared. Results Serum IgM and IgA in severe cases were significantly lower than those in normal cases and healthy controls (tIg M = 3.614, 4.127; tIg A = 3.152, 3.873, P <0.05) Ig G levels were higher than those in severe cases and healthy controls (tIg G = 2.951,3.236, P <0.05). Compared with normal control group and normal control group, T cell subsets CD3 + (TCD3 + = 3.314,4.247; tCD4 + = 3.124,4.043; tCD4 + / CD8 + = 3.251,3.867; tCD8 + = 3.326,3.915, P <0.05). The proportion of CD4 + and CD4 + / CD8 + . Conclusions After Cox A16 virus infection, the humoral immunity is inhibited in children and the cellular immune function is decreased, which may be related to its pathogenesis.