不同病原体感染手足口病患儿炎性因子变化与病情转归临床分析

摘要

Objective To analyze the immune function and clinical outcome of hand-mouth-foot disease children infected by different pathogens and summarize related treatment experience.Methods A retrospective analysis was per-formed where clinical data from 1 039 child patients with hand-mouth-foot disease were used.These patients were divid-ed into different groups according to their results of pathogen detection:an EV71 positive group ( n=179) , a CoxA positive group (n=121), an EV71 and CoxA positive group (n=38), and an EV71 and CoxA negative group (n=701).Then, these groups were compared for recovery time and the levels of IL-6 and IL-10.Results The EV71 positive group, the CoxA positive group, and the EV71 and CoxA positive group produced remarkably extended recovery time of rash, body temperature and appetite than the EV71 and CoxA negative group (P<0.01).Higher levels of IL-6 and IL-10 were de-tected in the EV71 and CoxA positive group than the other three groups (P<0.01).Conclusion For hand-mouth-foot child patients, those carrying pathogens show markedly extended recovery time for rash, body temperature and appetite as well as elevated levels of inflammatory factors, especially for those carrying both EV71 and CoxA.%目的：通过分析不同病原体感染手足口病患儿病程中免疫功能改变及临床转归，探讨手足口病的临床治疗经验。方法回顾性分析1039例手足口病患儿的临床资料，根据病原体检测分为EV71阳性组（179例）、CoxA阳性组（121例）、EV71及CoxA均阳性组（38例）、EV71及CoxA均阴性组（701例）。对各组临床症状、体征等的恢复时间及血清IL－6、IL－10水平进行比较。结果 EV71阳性组、CoxA阳性组、EV71及CoxA均阳性组患儿皮疹消退时间、体温恢复正常时间和进食好转时间均较EV71及CoxA均阴性组明显延长（P＜0．01）。 EV71及CoxA均阳性组患儿血清IL－6、IL－10水平明显高于EV71阳性组、CoxA阳性组、EV71及CoxA均阴性组（ P＜0．01）。结论手足口病病原体阳性患儿皮疹消退时间、体温恢复正常时间和进食好转时间均明显延长，炎性因子水平升高明显，且EV71及CoxA均阳性患儿重症倾向明显增高。