Study On Immune Function Changes In Children With Hand,Foot And Mouth Disease

ObjectiveTo explore the changes of immune function in children with hand,foot and mouth disease.and to provide a basis for the diagnosis and treatment of hand,foot and mouth disease.Methods:A total of 143 HFMD children admitted to the department of Pediatrics in our hospital from April 2019 to October 2019 were selected as the study subjects.The results were compared with 38 healthy children.All the children were tested for etiology within 3 days of admission.A total of 82 children were included in the study,including 13 children who were reinfected with other diseases 3 months after discharge and 48 children who refused to retest cellular immunity and humoral immunity during follow-up.Children were included in the experiment according to their disease stages and divided into acute stage group（n=82）:from the onset to the day of discharge,and the immediate after recovery group（n=82）:3 months after discharge.The age of the patients ranged from 1 to 3 years old,including 49 males and 33 females.The age ranged from 1 year old to 3 years old,with an average of 1.78±0.65 years old.The hospital stay ranged from 5 to 12 days,with an average of 5.341±2.21 days.From the patient’s disease situation,there are mainly ordinary type and severe syndrome type two groups;According to EV71 infection,they were divided into EV71 positive group and EV71 negative group.Peripheral venous blood detection of patients can effectively observe their immune status,such as T（CD3+）,Th（CD4+）,Ts（CD8+）,CD4+/CD8+,B（CD19+）,NK（CD 16+56+）,IgA,IgM and other indicators.In the form of comparison,the immune status of different categories of children was analyzed in detail.Meanwhile,a questionnaire was developed to timely follow up the disease situation of children after recovery and discharge.Through comprehensive sorting and analysis,the influence of various indicators of immune status on HAND-foot-mouth disease was clarified.Results:1.The CD3+,CD8+and CD4+levels in the acute stage group were significantly lower than those in the immediate post-recovery group,with statistically significant differences（ALL P<0.05）;2.After recovery,CD3+,CD4+and CD8+were significantly lower than those in the control group（P<0.05）.3.There were no significant differences in CD4+/CD8+,CD16+56+and CD 19+in acute stage group and short-term comparison after recovery（ALL P>0.05）.4.There were no significant differences in IgA,IgM and IgG between the acute stage group,the immediate after recovery group and the control group（all P>0.05）.5.The levels of CD3+,CD4+and CD8+in the normal type group were significantly lower than those in the severe syndrome group,with statistical significance（ALL P<0.05）.6.There were no significant differences in CD19+,CD4+/CD8+and CD 16+56+between the normal type group and the severe syndrome group（ALL P>0.05）.7.There were no significant differences in IgA,IgG and IgM between the general type group and the severe syndrome type group（ALL P>0.05）.8.Compared with the EV71 negative group,the levels of CD3+,CD4+and CD8+in the positive group were significantly lower than those in the negative group,with statistical significance（ALL P<0.05）;9.There were no significant differences in CD19+,CD4+/CD8+ and CD16+56+between EV71 positive group and EV71 negative group（ALL P>0.05）.10.There were no significant differences in IgA,IgG and IgM between EV71 positive group and EV71 negative group（all P>0.05）.11.The results of the questionnaire showed that the swallowing function of the healed children basically returned to normal,and all the new nails and muscle strength of the dearmored children were normal.Conclusion:1.Children with HFMD will have immune dysfunction in the acute stage;The degree of severe syndrome immune dysfunction is more serious than that of ordinary type.The immune dysfunction of children with POSITIVE EV71 was more severe than that of children with negative EV71.2.The immune function of the children with HFMD was improved in the near term（3 months）after the disease was cured,but there was still low immune function,which required strengthening nursing care to further prevent the occurrence of infectious diseases.