手足口病患儿外周血血管活性肠肽的表达

Expression of vasoactive intestinal peptide in peripheral blood of children with hand, foot and mouth disease

摘要:

目的 初步探讨手足口病患儿外周血血管活性肠肽的表达水平和意义。方法 根据病情将86例手足口病患儿分为1期组 （19例）和2期组 （67例）。采用ELISA法检测外周血血浆中血管活性肠肽、γ-干扰素 （IFN-γ）和白细胞介素-4 （IL-4）浓度。流式细胞术检测CD3⁺T、CD4⁺T、CD8⁺T淋巴细胞亚群。RTPCR法定性检测大便肠道病毒71型 （EV71）-RNA。结果 2期组EV71-RNA阳性率明显高于1期组 （P < 0.05）；2期组血清IgG、IgA、IgM、补体C3水平高于1期组 （P < 0.05）；2期组外周血CD3⁺T、CD4⁺T、CD8⁺T淋巴细胞亚群比例低于1期组 （P < 0.05）；2期组外周血B细胞比例高于1期组 （P < 0.05）；2期组CD4⁺/CD8⁺比值低于1期组 （P < 0.05）；2期组外周血血管活性肠肽浓度低于1期组 （P < 0.05）。86例手足口病患儿外周血血管活性肠肽浓度与CD4⁺T淋巴细胞亚群比例以及CD4⁺/CD8⁺比值呈正相关 （分别r=0.533、0.532，P < 0.05）。结论 血管活性肠肽可能是反映手足口病严重程度的重要标记物。

Abstract:

Objective To investigate the expression of vasoactive intestinal peptide (VIP) in peripheral blood of children with hand, foot and mouth disease and its significance. Methods According to the condition of the disease, 86 children with hand, foot and mouth disease were classified into phase 1 group (19 children) and phase 2 group (67 children). ELISA was used to measure the concentrations of plasma VIP, interferon-γ (IFN-γ), and interleukin-4 (IL-4) in peripheral blood. Flow cytometry was used to measure CD3⁺, CD4⁺, and CD8⁺ T lymphocyte subsets. RT-PCR was used for qualitative detection of enterovirus 71 (EV71) RNA in stool. Results Compared with the phase 1 group, the phase 2 group had a significantly higher positive rate of EV71-RNA (P < 0.05) and significantly higher serum levels of IgG, IgA, IgM, and C3 (P < 0.05). The phase 2 group had significantly lower proportions of peripheral CD3+, CD4⁺, and CD8⁺ T lymphocyte subsets than the phase 1 group (P < 0.05), as well as significantly lower proportion of peripheral B cells and CD4⁺/CD8⁺ ratio than the phase 1 group (P < 0.05). The phase 2 group also had a significantly lower concentration of VIP in peripheral blood than the phase 1 group (P < 0.05). In the 86 children with hand, foot and mouth disease, the concentration of VIP in peripheral blood was positively correlated with the proportion of CD4⁺ T lymphocyte subset and CD4⁺/CD8⁺ ratio (r=0.533 and 0.532 respectively; P < 0.05). Conclusions VIP may be an important marker of the severity of hand, foot and mouth disease.