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当代医学 2017年4月第23卷第12期总第455期 Contemporary Medicine, Apr.2017,Vol.23 No.12 Issue No.455鼠神经生长因子对危重型小儿手足口病患者体液免疫和细胞因子的影响刘静（四川省达州市中西医结合医院，四川 达州 635000）摘要：目的 分析鼠神经生长因子在治疗危重型小儿手足口病患者时对其体内细胞因子和体液免疫的干扰作用。方法 以94例危重型小儿手足口病患者为探究对像。47例危重型小儿手足口病患者给予喜炎平注射液治疗的同时肌肉注射鼠神经生长因子作为观察组，及同期只给予喜炎平注射液治疗的47例危重型小儿手足口病患者作为对照组。于治疗前后同时检测两组患儿体内细胞因子指标（IgA、IgG、IgM）和体液免疫的指标（CD8 + 、CD4 + 、CD4 + /CD8 + ）的变化情况。并将两组所得的数据进行比较。结果 治疗后两组患者体内三种细胞因子指标和三种体液免疫指标的浓度较治疗前均有明显提高（ P ＜0.05），且观察组患者体内三种细胞因子指标和三种体液免疫指标的浓度显著高于对照组（ P ＜0.05）。结论 鼠神经生长因子可以提高危重型小儿手足口病患者体细胞因子及体液免疫因子的水平从而发挥更好的疗效。关键词：鼠神经生长因子；危重型小儿手足口。幌赴蜃樱惶逡好庖逧ffect of mouse nerve growth factor on humeralimmunity and cell factor in severe pediatric patientswith hand foot and mouth disease in childrenLiu Jing(The hospital of integrated traditional Chinese and western Medicine of Dazhou City in Sichuan, Dazhou, Sichuan, 635000, China)Abstract: Objective To analyze the interferential effect of mouse nerve growth factor on cell factor and humeral immunity in patients with se-vere hand foot and mouth disease. Methods 94 patients with hand, foot and mouth disease were selected as the research object. 47 severe pediatricpatients with hand foot mouth disease in the observation group were treated with xiyanping injection and at the same time, the mouse nerve growthfactor was injected. And another 47 severe pediatric patients with hand foot mouth disease in the control group were treated with only xiyanping in-jection. Before and after treatment, the changes of cytokines (IgA, IgG, IgM) and humeral immunity indexes (CD8 + , CD4 + , CD4 + /CD8 + ) in childrenwere detected in the two groups. And the data of the two groups were compared. Results After treatment, the concentrations of three cytokines andthree kinds of humeral immune indexes in the children in two groups were more significantly increased than those before treatment (P ＜ 0.05). In theobservation group, the concentration of three cytokines and three kinds of humeral immune indexes were significantly higher than those in the con-trol group (P ＜ 0.05). Conclusion The mouse nerve growth factor can improve the level of body and humeral immune factors in critical childrenwith hand foot and mouth disease, so as to play a better therapeutic effect.Key words: Mouse nerve growth factor; Severe hand foot and mouth disease; Cell factor; Humeral immunity手足口。╤and，foot and mouth disease，HFMD）是由肠道病毒引起的传染性疾。梅⒂诙，尤以3岁以下年龄组发病率较高，大部分患儿不需经过特殊治疗，大约7日病情自痊愈，但小部分患儿病情较重无法自愈，且会产生严重并发症，如脑膜炎、脑炎、脑脊髓炎、肺水肿和循环障碍等，甚至威胁患儿生命，故应给予足够的重视 [1] 。危重型手足口病是由肠道病毒71型和柯萨奇病毒A组16型引起的，主要表现为发热、口腔疼痛、食欲不振、口腔和手足等部位斑丘疹、疱疹，并出现神经系统受累表现，精神萎靡、呕吐、肢体抖动或震颤、无力、头痛、口唇发绀、咳嗽、肺部可闻及湿啰音或痰鸣音等临床症状 [2] 。针对本病治疗效果并不令人满意，有研究发现，鼠神经生长因子治疗危重型手足口病患儿效果优良 [3] 。鼠神经生长因子（mNGF）为作用于神经系统的一种生物活性物质，可对神经细胞起到营养及保护的作用。本研究以94例危重型HFMD患儿为对象，剖析患儿应用mNGF治疗后，对患儿体内细胞因子指标（IgA、IgG、IgM）和体液免疫的指标（CD8 + 、CD4 + 、CD4 + /CD8 + ）的变化情况，现陈述如下。1 资料与方法1.1 临床资料 选取重庆达州市中西医结合医院儿科2015年9月～2016年9月收治的94例危重型HFMD患儿为研究对象。所有入选的研究对象都满足我们国家所制定的《手足口病诊疗指南》2010年版 [4] 。在喜炎平注射液治疗的同时加用mNGF治疗的47例患儿作为观察组，其中男23例，女24例，年龄0.5～4.5岁，平均（2.57±1.71）岁，患病时长21～93 d，平均（50.13±1.94）d。同期只给予喜炎平注射液治疗— — 38网络出版时间：2017-04-22 11:21:50网络出版地址：http://kns.cnki.net/kcms/detail/11.4449.R.20170422.1121.032.html