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目的观察重症手足口病(HFMD)患儿血清星形胶质源性蛋白(S100B)和神经元特异性烯醇化酶(NSE)水平与T淋巴细胞亚群的变化及相关性,并讨论其临床价值。方法选取2015年1~9月收治的HFMD患儿156例,包括普通病例80例(普通组),重症病例76例(重症组),另外选取70例健康幼儿作为对照组。采用流式细胞技术检测外周血T淋巴细胞亚群,采用ELISA法检测血清S100B和NSE水平,并分析血清S100B和NSE水平与T淋巴细胞亚群的相关性。结果与对照组比较,普通组和重症组T淋巴细胞总数、CD4~+、CD8~+、CD4~+/CD8~+均降低,且重症组降低更加明显(P<0.01)。与对照组和普通组比较,重症组血清S100B水平(1.64±0.28)μg/L和NSE水平(52.83±4.68)ng/ml均升高(P<0.01)。重症组血清S100B和NSE水平与T淋巴细胞亚群呈负相关(P<0.01)。结论T淋巴细胞亚群和血清S100B、NSE水平指标组合对于重症手足口病的早期识别具有一定的参考价值。
Objective To observe the changes and correlations between serum levels of astroglial protein (S100B) and neuron specific enolase (NSE) and T lymphocyte subsets in children with severe hand-foot-mouth disease (HFMD) value. Methods A total of 156 HFMD cases admitted from January to September in 2015 were selected, including 80 cases of normal group and 76 cases of severe cases (severe group). Another 70 healthy children were selected as control group. Serum levels of S100B and NSE were detected by ELISA. The correlation between serum levels of S100B and NSE and T lymphocyte subsets was analyzed by flow cytometry. Results Compared with the control group, the total number of T lymphocytes, CD4 ~ +, CD8 ~ +, CD4 ~ + / CD8 ~ + in normal group and severe group decreased significantly, especially in severe group (P <0.01). Serum S100B level (1.64 ± 0.28) μg / L and NSE level (52.83 ± 4.68) ng / ml in severe group were significantly higher than those in control group and general group (P <0.01). Serum levels of S100B and NSE in severe group were negatively correlated with T lymphocyte subsets (P <0.01). Conclusion The combination of T lymphocyte subsets and serum S100B and NSE levels may be of reference value for the early identification of severe HFMD.