目的：探索干扰素TLR3-TBK1-IRF-3信号通路在EV71手足口病脑炎中枢神经系统损伤中的作用机制。方法选取2014年1月至2015年1月手足口病患儿144例（观察组）及健康体检儿童36例（对照组），通过脑脊液检查及临床诊断，分成5组，正常儿童体检组、普通手足口病儿童2d组（A组）、普通手足口病儿童5d组（B组）、手足口病脑炎2d组（C组）、手足口病脑炎5d组（D组），每组各36名儿童，用ELISA方法检测患儿血液中TLR3、TBK1、IRF-3、TRIF蛋白及干扰素的表达水平。结果观察组干扰素的表达水平明显高于对照组（P<0.01），A组和C组差异无统计学意义，B组明显高于D组（P<0.01），A组与B组、D组与C组差异无统计学意义；观察组TLR3、TBK1、IRF-3、TRIF及蛋白的表达水平明显高于对照组（P<0.01），A组和C组比较差异无统计学意义，B组明显高于D组（P<0.01），B组高于A组（P<0.01）、D组与C组比较差异无统计学意义。结论手足口病脑炎患儿干扰素及TLR3、TBK1、IRF-3、TRIF蛋白的表达水平较正常儿童明显升高，但比普通手足口病患儿较低，提示TLR3-TBK1-IRF-3信号通路对手足口病脑炎具有一定的诊断意义。%Objective To investigate the role of TLR3-TBK1-IRF-3 signal pathway in EV71-induced encephalitis of hand food and mouth disease. Methods The study was conducted at second Affiliated Hospital and Yuying Children Hospital of Wenzhou Medical College from January 2014 to January 2015,based on blood examination,CSF routine test and clinical manifestation. There are 180 members and divided into five groups,each group includes 36. 2day control group(2C),2day hand-food-mouth(2h),5day hand-food-mouth(5h),2day hand-food-mouth and encephalitis (2e),5day hand-food-mouth and encephalitis(5e). Elisa and western blot were used to detect the expressions of certain signal pathway related proteins in blood. Results Elisa assay:the levels of interferon,TLR3、TBK1、IRF-3、TRIF protein expression in the groups of patients were significantly increased than that of the corresponding control groups,(P<0.01),especially the 5h group,there is no significant difference found between 2e group and 2h group,it is the same between 2e and 5e group. Conclusions the levels of the levels of interferon,TLR3、TBK1、IRF-3、TRIFprotein expression in the groups of hand food mouth disease and encephalitis were significant increased,but less expression than that groups of general hand food mouth disease,these suggest that TLR3-TBK1-IRF-3 signal pathway has a great role in the diagnosis of hand food mouth disease and encephalitis.
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