A Study Of Variation Of Cellular Immunity In Severe Hand-Foot-Mouth Disease

Objective:To evaluate the variation of cellular immunity in severe hand,foot and mouth disease(HFMD).Method : Databases including CNKI,VIP,CBM,Wan Fang Data,Pub Med,Medline,web of science,Ovid and The Cochrane Library were searched to collect researches about the variation of cellular immunity in severe hand,foot and mouth disease from inception(CNKI 1999 year?Wan Fang Data 1998 year?CBM 1978 year?VIP 1989 year?Cochrane Library 1992 year?medline 1997 year?pubmed 1997 year?web of science 1997 year?Ovid 1984 year)to May 2017.Two reviewers independently screened literatures,extracted data and assessed the quality of included studies.Then,meta-analysis was performed by using Rev Man 5.3.According to clinical manifestation,studies were divided into three parts of common group(group A),severe group(group B),health group(group C).The variation of cellular immunity was compared from three parts.Result : A total of 42 literatures were included.The results of meta-analysis :1.severe group compared with common group CD3+ cell:(MD)=-9.30,95%CI:-14.17~-4.42;P=0.00002,P<0.05.CD4+ cell:(MD)=-6.15,95%CI:-9.27~-3.03;P=0.0001,P<0.05.CD8+ cell:(MD)=-2.13,95%CI:-3.92~-0.34;P=0.02,P<0.05.CD4+ cell /CD8+ cell:(MD)=-0.20,95%CI:-0.27~-0.14;P<0.00001,P<0.05.NK cell:(MD)=-1.81,95%CI:-4.59~-0.98;P=0.2,P>0.05?B lymphocyte:(MD)=2.83,95%CI:-0.34~5.99;P=0.08,P>0.05.2.severe group compared with health group CD3+ cell:(MD)=-16.09,95%CI:-20.62~-11.56;P<0.00001,P<0.05? CD4+ cell:(MD)=-11.10,95%CI:-13.68~-8.52;P<0.00001,P<0.05.CD8+ cell:(MD)=-3.43,95%CI:-5.52~-1.33;P=0.001,P<0.05.CD4+ cell /CD8+ cell:(MD)=-0.47,95%CI:-0.63~-0.31;P<0.00001,P<0.05.NK cell:(MD)=-1.73,95%CI:-5.87~2.42;P=0.41,P>0.05.B lymphocyte:(MD)=12.65,95%CI:9.68~15.63;P<0.00001,P<0.05.3.common group compared with health group CD3+ cell:(MD)=-10.10,95%CI:-12.72~-7.47;P<0.00001,P<0.05.CD4+ cell:(MD)=-5.08,95%CI:-6.42~-3.75;P<0.00001,P<0.05.CD8+ cell:(MD)=-1.57,95%CI:-2.93~-0.21;P=0.02,P<0.05.CD4+cell/CD8+ cell:(MD)=-0.15,95%CI:-0.27~-0.03;P=0.02,P<0.05.NK cell:(MD)=-0.43,95%CI:-2.63~1.78;P=0.7,P>0.05?B lymphocyte:(MD)=10.06,95%CI:7~13.11;P<0.00001,P<0.05.Conclusion :CD3+cell ? CD4+cell ? CD8+cell ? CD4+cell/CD8+cell are related to the state of hand,foot and mouth disease,all decrease significantly in severe hand,foot and mouth disease.Monitoring the cell immune function in severe hand-foot-mouth disease will be useful for evaluating the illness state and the diagnose.Due to the limited quality of the included studies,more high quality studies are needed to testify the above conclusion.