重症手足口病患儿外周血炎性因子、神经元特异性烯醇化酶与中枢神经特异性S100β蛋白水平变化

doi:10.3877/cma.j.issn.1674-1358.2019.03.014

中华实验和临床感染病杂志(电子版) ›› 2019, Vol. 13 ›› Issue (03) : 250 -254. doi: 10.3877/cma.j.issn.1674-1358.2019.03.014

所属专题：文献；

论著

重症手足口病患儿外周血炎性因子、神经元特异性烯醇化酶与中枢神经特异性S100β蛋白水平变化

庞文箫¹, 易冬玲², 张朝勇², 蓝英², 曾现芬², 曾义岚², 刘勇¹^,^†(

)

^1. 610066　成都市，成都市公共卫生临床医疗中心传染病研究室
^2. 610066　成都市，成都市公共卫生临床医疗中心传染儿科

收稿日期:2018-10-26 出版日期:2019-06-15
通信作者: 刘勇
基金资助:
成都市科技局惠民项目(No. 2013-HM01-00178-SF); 成都市卫计委(No. 2014025); 成都市卫计委(No. 2014035)

Changes of inflammatory factors, neuron-specific enolase and central nervous system specific protein S100β in peripheral blood of children with severe hand, foot and mouth disease

Wenxiao Pang¹, Dongling Yi², Zhaoyong Zhang², Ying Lan², Xianfen Zeng², Yilan Zen², Yong Liu¹^,^†()

^1. Infectious Diseases Research Public Office, Health Clinical Center of Chengdu, Chengdu 610066, China
^2. The Department of Pediatric Infection, Health Clinical Center of Chengdu, Chengdu 610066, China

Received:2018-10-26 Published:2019-06-15
Corresponding author: Yong Liu
About author:
Corresponding author: Liu Yong, Email: plantonic@163.com

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引用本文：

庞文箫, 易冬玲, 张朝勇, 蓝英, 曾现芬, 曾义岚, 刘勇. 重症手足口病患儿外周血炎性因子、神经元特异性烯醇化酶与中枢神经特异性S100β蛋白水平变化[J]. 中华实验和临床感染病杂志(电子版), 2019, 13(03): 250-254.

Wenxiao Pang, Dongling Yi, Zhaoyong Zhang, Ying Lan, Xianfen Zeng, Yilan Zen, Yong Liu. Changes of inflammatory factors, neuron-specific enolase and central nervous system specific protein S100β in peripheral blood of children with severe hand, foot and mouth disease[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2019, 13(03): 250-254.

目的

研究重症手足口病（HFMD）患儿外周血白细胞介素（IL）-6、IL-10、IL-17、神经元特异性烯醇化酶、中枢神经特异性蛋白S100β的变化。

方法

以60例手足口病患儿为研究对象，其中轻症患儿30例（轻症组）和重症30例（重症组），另选取30例健康儿童为对照组；采用双抗体夹心酶联免疫吸附实验检测各组患儿外周血IL-6、IL-10、IL-17、NSE和S100β水平。

结果

与对照组、轻症患儿相比，重症手足口病患儿外周血IL-6、IL-10、IL-17水平均显著升高，差异有统计学意义（重症组vs.对照组：t = 9.83、8.56、7.85，P = 0.043、0.019、0.011；重症组vs.轻症组：t = 5.84、4.95、6.59，P = 0.023、0.032、0.024）。与对照组患儿相比，轻症患儿外周血IL-6、IL-10、IL-17水平稍有升高，但差异无统计学意义（t = 0.53、1.03、0.38，P = 0.292、0.445、0.362）。与对照组和轻症组相比，重症组患儿外周血NSE和S100β的水平显著升高，差异有统计学意义（重症组vs.对照组：t = 11.39、9.25，P = 0.018、0.016；重症组vs.轻症组：t = 5.44、6.3，P = 0.031、0.028）。与对照组相比，轻症患儿外周血NSE、S100β均有升高，但无统计学意义（t = 1.38、1.89，P = 0.098、0.142）。

结论

手足口病患儿外周血IL-6、IL-10、IL-17、NSE和S100β水平升高，可提示病情严重程度；临床监测以上指标变化，可早期发现重症患者，尽早治疗。

关键词: 手足口病, 炎性因子, 神经元特异性烯醇化酶, 中枢神经特异性蛋白S100β

Objective

To investigate the changes of interleukin (IL)-6, IL-10, IL17, neuron-specific enolase and central nervous specific protein S100β of peripheral blood in children with hand, foot and mouth disease (HFMD).

Methods

Total of 60 children with HFMD were collected, including 30 children with mild symptoms (mild group) and 30 children with severe symptoms (severe group), while 30 healthy children were selected as control group. The expression of IL-6, IL-10, IL-17, NSE and S100β in peripheral blood of children in each group were detected by double antibody sandwich enzyme-linked immunosorbent assay (ELISA).

Results

The levels of IL-6, IL-10 and IL-17 in peripheral blood of children in severe group were significantly higher than those of the control group and mild group, all with significant differences (severe group vs. control group: t = 9.83, 8.56, 7.85; P = 0.043, 0.019, 0.011. severe group vs. mild group: t = 5.84, 4.95, 6.59; P = 0.023, 0.032, 0.024). Compared with the control group, the levels of IL-6, IL-10 and IL-17 in peripheral blood of children in mild group were slightly higher, but there were no significant differences (t = 0.53, 1.03, 0.38; P = 0.292, 0.445, 0.362). Compared with the control group and mild group, the levels of NSE and S100β in peripheral blood of children in severe group were significantly higher, with significant differences (severe group vs. control group: t = 11.39, 9.25; P = 0.018, 0.016. severe group vs. mild group: t = 5.44, 6.30; P = 0.031, 0.028). Compared with the control group, the levels of NSE and S100β in peripheral blood of children in mild group were higher, but with no significant differences (t = 1.38, 1.89; P = 0.098, 0.142).

Conclusions

The levels of IL-6, IL-10, IL-17, NSE and S100β in peripheral blood of children with HFMD were increased, which could indicate the severity of the disease, and the changes of the above indexes could be detected in the early stage of severe patients and treated as soon as possible.

Key words: Hand, foot and mouth diease, Cytokine, Neuron specific enolase, Soluble protein-100β

表1 三组研究对象的基本资料

组别	例数	年龄（±s，岁）	性别（男/女，例）	体重（±s，kg）	病原分型[例（%）]		入院至采血时间（±s，h）
组别	例数	年龄（±s，岁）	性别（男/女，例）	体重（±s，kg）	EV71（+）	非EV71（+）	入院至采血时间（±s，h）
轻症组	30	2.31 ± 1.05	16/14	3.1 ± 2.4	8（26.67）	22（73.34）	41.08 ± 3.26
重症组	30	2.11 ± 0.98	18/12	2.9 ± 2.1	24（80.00）	6（20.00）	36.88 ± 3.18
对照组	30	2.36 ± 1.66	17/13	3.3 ± 2.7	—	—	—
统计量	?	F= 0.890	χ²= 4.230	F= 0.960	χ²= 17.067		t = 0.760
P值	?	0.420	0.646	0.560	<0.001		0.620

表1 三组研究对象的基本资料

组别	例数	年龄（±s，岁）	性别（男/女，例）	体重（±s，kg）	病原分型[例（%）]		入院至采血时间（±s，h）
组别	例数	年龄（±s，岁）	性别（男/女，例）	体重（±s，kg）	EV71（+）	非EV71（+）	入院至采血时间（±s，h）
轻症组	30	2.31 ± 1.05	16/14	3.1 ± 2.4	8（26.67）	22（73.34）	41.08 ± 3.26
重症组	30	2.11 ± 0.98	18/12	2.9 ± 2.1	24（80.00）	6（20.00）	36.88 ± 3.18
对照组	30	2.36 ± 1.66	17/13	3.3 ± 2.7	—	—	—
统计量	?	F= 0.890	χ²= 4.230	F= 0.960	χ²= 17.067		t = 0.760
P值	?	0.420	0.646	0.560	<0.001		0.620

表2 三组研究对象外周血IL-6、IL-10和IL-17水平（ ± s）

组别	例数	IL-6（pg/L）	IL-10（pg/L）	IL-17（pg/ml）
对照组	30	28.4 ± 6.1	13.83 ± 0.78	92.5 ± 15.36
轻症组	30	44.5 ± 6.23	28.59 ± 0.85	117.8 ± 25.89
重症组	30	78.47 ± 7.79	46.48 ± 0.67	228.9 ± 31.16
F值	?	40.060	93.190	10.950
P值	?	<0.001	<0.001	<0.001

表2 三组研究对象外周血IL-6、IL-10和IL-17水平（ ± s）

组别	例数	IL-6（pg/L）	IL-10（pg/L）	IL-17（pg/ml）
对照组	30	28.4 ± 6.1	13.83 ± 0.78	92.5 ± 15.36
轻症组	30	44.5 ± 6.23	28.59 ± 0.85	117.8 ± 25.89
重症组	30	78.47 ± 7.79	46.48 ± 0.67	228.9 ± 31.16
F值	?	40.060	93.190	10.950
P值	?	<0.001	<0.001	<0.001

表3 三组研究对象外周血NSE和S100β水平（ ± s，μg/L）

组别	例数	NSE	S100β
对照组	30	30.27 ± 1.64	2.56 ± 0.47
轻症组	30	44.58 ± 1.46	4.12 ± 0.37
重症组	30	67.47 ± 2.67	6.42 ± 0.72
F值	?	23.190	59.160
P值	?	<0.001	<0.001

表3 三组研究对象外周血NSE和S100β水平（ ± s，μg/L）

组别	例数	NSE	S100β
对照组	30	30.27 ± 1.64	2.56 ± 0.47
轻症组	30	44.58 ± 1.46	4.12 ± 0.37
重症组	30	67.47 ± 2.67	6.42 ± 0.72
F值	?	23.190	59.160
P值	?	<0.001	<0.001

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