目的 了解5种炎症因子MCP 1、IL-1β、IL-18、HMGB1、IL-10在重症EV71型手足口病(HFMD)中的临床意义.方法 选取某院2014年3 8月确诊为重症EV71型HFMD的住院患儿为HFMD组,同期本院门诊体检的健康儿童为对照组,动态观察两组外周血MCP 1、IL-1β、IL-18、HMGB1、IL-10表达水平的变化,并收集HFMD组临床资料.结果 HFMD组共102例患儿,平均年龄为(2.18±0.91)岁,其中主要以≤3岁为主,占80.39％;HFMD组患儿入院时为第2期77例,第3期16例,第4期9例.经过第2期共77例,第3期共52例,第4期共21例,第5期共88例.HFMD组第2、3、4期分别与对照组的5种炎症因子表达水平比较,差异均有统计学意义(均P＜0.05);HFMD组第3期与第4期的IL-10表达水平比较,差异无统计学意义(P＞0.05).HFMD组第2、3期进展组HMGB1表达水平均高于痊愈组,差异均有统计学意义(均P＜0.05).死亡组与存活组在入院时5种炎症因子表达水平的比较,差异均有统计学意义(均P＜0.05).结论 MCP 1、HMGB1、IL-1β、IL-10、IL 18的表达水平与HFMD病情轻重相关,对患儿预后的预测有一定临床意义.HMBG1在HFMD中对病情转归有一定预测价值.%Objective To investigate the clinical significance of 5 kinds of inflammatory factors (MCP 1,IL 1β,IL-18,HMGB1,and IL-10) in severe EV71 hand-foot-and-mouth disease (HFMD).Methods Hospitalized children who were diagnosed with severe EV71 HFMD in a hospital in March August,2014 were as HFMD group,healthy children who underwent physical examination in outpatient department of the same hospital during the sameperiod were as control group,changes in expression levels of peripheral blood MCP-1,IL-1β,IL-18,HMGB1,and IL-10 of both groups were dynamically observed,clinical data of HFMD group were collected.Results There were 102 children in HFMD group,the average age was (2.18 ± 0.91) years old,80.39％ of whom were ≤3 years old;there were 77,16,and 9 cases in HFMD group at stage 2,3,and 4 respectively at admission.77,52,21,and 88 cases went through stage 2,3,4,and 5 respectively.Expression levels of 5 kinds of inflammatory factors at stage 2,3,and 4 in HFMD group were compared respectively with control group,differences were all statistically significant(all P＜0.05);expression levels of IL-10 at stage 3 and 4 in HFMD group were not significantly different (P＞0.05).In HFMD group,the expression levels of HMGB1 of stage 2,3 progression groups were both higher than recovery group(both P＜0.05).The expression levels of 5 kinds of inflammatory factors in the death group and survival group at admission were all significantly different (all P＜0.05).Conclusion The expression levels of MCP 1,HMGB1,IL-1β,IL-10,and IL-18 are closely related to the severity of HFMD,and has certain clinical significance for the prognosis of children.HMBG1 has certain predictive value in the prognosis of HFMD.
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