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目的:研究重症手足口病患儿外周T淋巴细胞亚群水平变化,探讨其免疫功能改变。方法:以临床确诊的70例重症手足口病患儿为研究对象,随机分为治疗组和对照组,检测血CD3、CD4、CD8、CD19、NK、CD4/8、T+B+NK。对照组采用降低颅内压、控制炎症,丙种球蛋白、糖皮质激素免疫调节及降温、镇静、止惊等对症处理,治疗组加服匹多莫得片治疗,每次0.4 g,1日2次,从病程、转归结进行比较。结果:重型手足口病患儿的B细胞、NK细胞、总T细胞、CD4+细胞、CD4+/CD8+水平下降,差异有统计学意义(P<0.05);治疗组病程7.2天,均治愈,对照组病程11.4天,较治疗组延长,2例转为III期,差异有统计学意义(P<0.5)。结论:重症手足口病患儿存在细胞免疫功能降低,在治疗中需重视免疫功能的检查,及时调节机体的免疫功能,维持免疫的自稳性,早期干预治疗,应用匹多莫得免疫调节,可控制病情,改善转归,从而减少并发症的发生和降低病死率。
Objective: To study the changes of peripheral T lymphocyte subsets in children with severe hand-foot-mouth disease and to explore the changes of immune function. Methods: A total of 70 clinically diagnosed HFMD patients were randomly divided into treatment group and control group. Blood CD3, CD4, CD8, CD19, NK, CD4 / 8 and T + B + NK were measured. In the control group, intracranial pressure was decreased, inflammation was controlled, immunoglobulin, glucocorticoid immunoregulation and symptomatic treatment such as cooling, sedating and stopping shock were used. The treatment group was treated with pidotimod tablets at a dose of 0.4 g per day for 2 days Times, from the course of the disease, the outcome of the comparison. Results: The levels of B cells, NK cells, total T cells, CD4 + cells and CD4 + / CD8 + in children with HFMD decreased significantly (P 0. 05). The duration of treatment in the treatment group was 7.2 days, Duration of 11.4 days, longer than the treatment group, 2 cases turned to stage III, the difference was statistically significant (P <0.5). Conclusion: There is a reduction in cellular immune function in children with severe hand-foot-mouth disease. In the treatment, attention should be paid to the examination of immune function, timely regulation of the immune function, maintenance of self-stability of immunity, early intervention therapy, Can control the disease, improve prognosis, thereby reducing the incidence of complications and reduce mortality.