The Clinical Significance Of Detecting Immunoglobulin、CRP、complement And CD80、CD86 In The Children With HFMD And Analysis Of The Results With The Treatment Of Globulin

Objective: To investigate the the level of immunoglobulin, CRP, complement and CD80, CD86 in the children with HFMD and the relationship between the results and the severity of the disease, we also analyze the correlation between the levels of the proteins and the results of treatment of globulin for the prognosis of children.Methods: The 45 children with HFMD were selected from PLA 251 Hospital From January to December in 2014, the diagnostic standards were according to《HFMD Clinic Guide Version 2013》. The children with HFDM were divided into ordinary group and severe group. The ordinary group had 25 cases, among which there were 10 males and 15 females, the ages ranged from 3 months to 6 years. The average age was(1.5±0.8)years. And the severe group had 20 cases, 12 males and 8 females, the ages ranged from 6 months to 3 years. The average age was(1.2±0.2)years. We also collected 15 cases as control, 8 males and 7 females, the ages ranged from 1 to 6 years. The average age was(2.3±0.9) years. Excluding standards: the age is older than six, or the children had immune system diseases, or the parents of the children quit the treatment in the halfway or transfer to another hospital. The levels of immunoglobulin, CRP, complement and CD80, CD86 of these children were detected and compared with the difference of these indexes. The two groups children were treated normally, divided the children of serious HFMD into A and B group, the children were both treated with ribavirin、pediatric amino acid、electrolyte、methyl prednisolone, mannitol and other nutritional support symptomatic treament, the B group also used IVIG besides the A group treatment way, compared the indexes of the two groups, and analyzed the relationship between IVIG treatment group or not.Results:1 The levels of serum Ig M, Ig G, Ig A in children with HFMD severe group and ordinary group were significantly lower than that in control group, the difference was statistically significant(P <0.01).2 There was no significant difference of the complement C3, C4 content between ordinary group and severe A, B two groups(P> 0.05), the content of CRP in severe HFMD group was significantly higher than that in normal group and the control group(P <0. 05).3 Compare ordinary group, severe group and control group of children proportion of CD80 and CD86 cells, the difference was statistically significant(P = 0.000), CD80 HFMD compare severe A, B two groups of children, and the proportion of CD86 cells, the difference was not statistically significant(P> 0.05), Comparison of the control group and severe A, B two groups of children with HFMD CD80 and CD86 cell ratio, the difference statistically significant(P <0.01).4 The level of TNF-α, CRP and IL-6 in Severe A, B two subgroups were significantly higher; the difference was statistically significant(P <0.05); Before the treatment, the TNF-ɑ, CRP, IL-6 levels were measured in A, B two subgroups, the difference was not statistically significant(P> 0.05), after treatment, TNF-ɑ, CRP, IL-6 levels were significantly lower, where the index was significantly lower than in group B A group, the difference was statistically significant(P <0.05).Conclusion:1 Serum Ig M, Ig G, Ig A levels in HFMD children were significantly lower than that in healthy children. Description enterovirus infection can make changes in the humeral immune function, but also has correlated with disease progression.2 Serum C3 and C4 level in HFMD children was no significant difference in complement levels compared with healthy children, complement C3 and C4 show did not play a very important role in the development of the disease.3 CD80 cells and CD86 cells in HFMD children were significantly higher, indicating that CD80 and CD86 play a participatory role during the development of HFMD.4 CRP, TNF-ɑ and IL-6 levels were significantly higher in HFMD children than healthy children before treatment, after treatment, the level of CRP, TNF- ɑ and IL- 6 were significantly reduced, but subgroup B index level was significantly lower in children A subgroup, indicating that IVIG HMFD significant effect in the treatment, the inflammation in HFMD children can be effectively reduced and the recovery process is promoted.