E V 71阳性手足口病患儿 T reg 细胞、T H 17细胞、T G F-β、IL-6等细胞因子的检测及临床意义

摘要

Objective] To explore the pathogenesis and clinical significance of the positive EV 71 HFMD children and their correlation with the peripheral blood T cell 17 (Th17) ,CD4+ CD25+ regulation T cells (CD4+CD25+ Treg) ,the cytokines interleukin‐6 (IL‐66) ,IL‐10 ,IL‐17 and transformation growth factor‐β(TGF‐β)[.Methods]The 267 cases of children with HFMD were selected as the research group ,including 165 cases of common type and 102 cases of severe type ,another 90 cases of healthy children as the control group ;ELISA was used to detect the expression levels of TGF‐,IL‐6 ,IL‐10 and IL‐17 in each group[.Results]Com‐pared with the control group ,Th17 cell ,IL‐10 ,IL‐6 and IL‐17 levels of the severe and common HFMD chil‐dren were significantly increased ( P < 0 .05);CD4+ CD25+ Treg cells ,TGF‐βlevels decreased significantly ( P <0 0.5);the peripheral blood T cell 17 (Th17) ,IL‐6 ,IL‐10 ,IL‐17 levels of HFMD children increased with the aggravation of disease ,and CD4+ CD25+ Treg cells and TGF‐β levels decreased with the severity of the disease[.Conclusion]EV71 positive HFMD children present cellular immune function disorders .Ratio im‐balance of Th17 and CD4+CD25+ Treg cell may play an important role in the pathogenesis of HFMD .%【目的】探讨手足口病（HFMD）患儿外周血辅助性 T细胞17（Th17）、CD4＋ CD25＋调节性 T细胞（CD4＋CD25＋ Treg ）以及细胞因子白介素‐6（IL‐6）、IL‐10、IL‐17、转化生长因子‐β（TGF‐β）等在EV71阳性HFMD患儿发病机制中的作用及临床意义。【方法】以267例 HFMD患儿为研究对象，其中普通型165例，重型102例，另选取90例健康儿童为对照组；采用流式细胞术检测各组外周血CD4＋ CD25＋ Treg 细胞、T h17细胞的表达；采用ELISA法检测 TGF‐β、IL‐6、IL‐10、IL‐17在各组的表达水平。【结果】与对照组相比，重型和普通型HFMD患儿的Th17细胞、IL‐6、IL‐10、IL‐17水平均明显升高（均 P ＜00．5），而CD4＋CD25＋ Treg 细胞、TGF‐β水平则显著下降（均 P ＜00．5），且HFMD患儿外周血 Th17、IL‐6、IL‐10、IL‐17水平随病情加重而增高，而CD4＋CD25＋ Treg 细胞、TGF‐β水平随病情严重而降低。【结论】EV71阳性HFMD患儿体内存在细胞免疫功能紊乱， T h17与CD4＋CD25＋ Treg 细胞比例失衡可能在 H FM D发病机制中起重要作用。