重症手足口病患儿血清炎性细胞因子动态变化与神经源性肺水肿的关系

被引：28

作者：

冯慧芬 ^{[1
]}

段广才 ^{[2
]}

朱光 ^{[1
]}

机构：

[1] 郑州大学第五附属医院感染科

[2] 郑州大学公共卫生学院流行病学教研室

来源：

中华实用儿科临床杂志 | 2015年 / 30卷 / 06期

关键词：

手足口病; 细胞因子; 动态变化; 神经源性肺水肿;

D O I：

暂无

中图分类号：

R725.1 [小儿传染病];

学科分类号：

100201 [内科学];

摘要：

目的探讨重症手足口病(HFMD)患儿血清炎性细胞因子动态变化及其与神经源性肺水肿(NPE)的关系。方法选择2010年3月至2012年12月89例住院重症HFMD患者, 按其是否发生NPE分为神经系统受累组(CNSD)与NPE组, 于入院后第1、3和5天采用酶链免疫吸附法检测血清IL-4、IL-10、IL-6、IL-17、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)水平, 多因素Logistic回归分析筛选NPE的危险因素。结果 1.NPE组IL-6(F时间=1.876, P=0.177;F交互=2.192, P=0.145;F组间=7.855, P=0.007)、TNF-α(F时间=13.133, P=0.001;F交互=0.291, P=0.592;F组间=3.644, P=0.042)、IL-10(F时间=14.580, P=0.001;F交互=2.612, P=0.078;F组间=16.823, P=0.000)、INF-γ(F时间=3.093, P=0.045;F交互=0.513, P=0.600;F组间=20.141, P=0.000)水平显著高于CNSD组。2.TNF-α、IL-10、INF-γ于入院第3天达到高峰。3.年龄(OR=3.383, 95%CI:1.173～4.759)、持续发热(OR=4.925, 95%CI:1.758～3.794)、血糖(OR=3.465, 95%CI:1.303～5.220)、白细胞计数(OR=7.579, 95%CI:2.530～12.704)及IL–10(OR=1.228, 95%CI:1.007～1.523)是重症HFMD发生NPE的危险因素。结论炎性细胞因子的动态失衡与NPE的发生、发展有关, 并可用于评估重症HFMD发生NPE的风险。

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