Effect of human immunoglobulin injection on inflammatory factors and immune function in children with severe hand-foot-mouth disease caused by EV71 infection

doi:10.3877/cma.j.issn.1674-0785.2022.02.005

Abstract

Abstract:

Objective

To evaluate the efficacy of human immunoglobulin injection combined with conventional treatment in children with severe hand-foot-mouth disease caused by enterovirus 71 (EV71) infection and explore the influence on inflammatory factors and immune function.

Methods

One hundred and twenty-six children with severe hand-foot-mouth disease caused by EV71 infection who were treated at Hainan Women and Children's Medical Center between December 2018 and December 2020 were selected and divided into either a control group or an observation group using the random number table method, with 63 cases in each group. Both groups received conventional treatment, and the observation group was additionally given human immunoglobulin injection. The effective rate of treatment, time to improvement of clinical symptoms, levels of serum inflammatory factors [C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), interleukin-17 (IL-17), interleukin-10 (IL-10), and transforming growth factor β₁ (TGF-β₁)], and peripheral blood T lymphocyte subsets were compared between the two groups, and the occurrence of adverse reactions was recorded.

Results

The total clinical effective rate of the observation group was significantly higher than that of the control group (87.30% vs 69.84%, P＜0.05). The time to normal recovery of normal body temperature and the time to disappearance of skin rash and oral ulcers in the observation group were significantly shorter than those in the control group (P＜0.05). After treatment, the levels of serum CRP, IL-6, TNF-α, and IL-17 in the observation group were lower than those in the control group (P＜0.05), while the levels of IL-10 and TGF-β₁ were higher than those in the control group (P＜0.05). After treatment, the proportions of CD3⁺ T cells, CD4⁺ T cells, and CD4⁺/CD8⁺ T cell ratio of the observation group were higher than those of the control group, while the proportion of CD8⁺ T cells was lower than that of the control group (P＜0.05). There were no adverse drug reactions in either group during treatment.

Conclusion

Human immunoglobulin injection combined with conventional treatment has high clinical efficacy in children with severe hand-foot-mouth disease caused by EV71 infection, and can promote the recovery of symptoms, which may be related to reducing the inflammatory response and improving immune function.

Key words: Enterovirus 71, Hand-foot-mouth disease, Human immunoglobulin injection, Inflammatory factors, Immune function

Manfen Xie, Yan Gao, Chenlu Cai, Xiao Wang, Huimin. Guo. Effect of human immunoglobulin injection on inflammatory factors and immune function in children with severe hand-foot-mouth disease caused by EV71 infection[J]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(02): 136-140.

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Figures/Tables 5

组别	例数	性别［例（%）］		年龄（岁， $x ¯$ ±s）	BMI （kg/m²， $x ¯$ ±s）	发病时间（d， $x ¯$ ±s）
组别	例数	男性	女性	年龄（岁， $x ¯$ ±s）	BMI （kg/m²， $x ¯$ ±s）	发病时间（d， $x ¯$ ±s）
观察组	63	35（55.56）	28（44.44）	3.32±1.05	15.59±0.52	3.15±0.84
对照组	63	32（50.79）	31（49.21）	3.48±1.08	15.45±0.55	3.23±0.79
t/χ²值		0.287		0.843	1.468	0.551
P值		0.592		0.401	0.145	0.583

组别	例数	性别［例（%）］		年龄（岁， $x ¯$ ±s）	BMI （kg/m²， $x ¯$ ±s）	发病时间（d， $x ¯$ ±s）
组别	例数	男性	女性	年龄（岁， $x ¯$ ±s）	BMI （kg/m²， $x ¯$ ±s）	发病时间（d， $x ¯$ ±s）
观察组	63	35（55.56）	28（44.44）	3.32±1.05	15.59±0.52	3.15±0.84
对照组	63	32（50.79）	31（49.21）	3.48±1.08	15.45±0.55	3.23±0.79
t/χ²值		0.287		0.843	1.468	0.551
P值		0.592		0.401	0.145	0.583

组别	例数	显效	改善	无效	总有效率
观察组	63	25（39.68）	30（47.62）	8（12.70）	55（87.30）
对照组	63	12（19.05）	32（50.79）	19（30.16）	44（69.84）
Z/χ²值					5.704
P值					0.017

组别	例数	体温复常时间	皮疹消退时间	口腔溃疡消退时间
观察组	63	1.86±0.45	3.14±0.47	4.57±1.28
对照组	63	3.78±0.50	4.62±0.58	6.14±1.35
t值		22.655	15.736	6.698
P值		＜0.001	＜0.001	＜0.001

组别	例数	CRP（mg/L）		TNF-α（μg/L）		IL-6（μg/L）
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	63	5.13±1.28	1.57±0.76^a	5.32±1.47	1.28±0.52^a	6.27±2.51	2.05±0.64^a
对照组	63	5.15±1.32	3.28±0.94^a	5.35±1.49	3.46±0.67^a	6.32±2.48	4.16±0.89^a
t值		0.086	11.228	0.114	20.402	0.112	15.278
P值		0.931	＜0.001	0.910	＜0.001	0.911	＜0.001
IL-17（pg/ml）		IL-10（pg/ml）		TGF-β₁（pg/ml）
治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
54.23±18.52	35.74±10.73^a	26.74±8.66	38.94±9.64^a	7653.74±1542.13	9887.45±1892.05^a
53.84±18.75	48.47±12.83^a	26.58±8.75	34.43±9.23^a	7648.89±1545.67	9042.18±1742.33^a
0.117	6.041	0.103	2.682	0.015	2.608
0.907	＜0.001	0.918	0.008	0.988	0.010

组别	例数	CD3⁺（%）
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	63	43.58±4.27	60.28±6.74^a	29.71±3.18	40.62±6.38^a	33.41±5.52	25.63±2.74^a	0.89±0.15	1.58±0.25^a
对照组	63	43.75±4.63	53.74±5.55^a	29.40±3.23	35.18±5.21^a	33.28±5.48	28.66±4.17^a	0.88±0.16	1.23±0.18^a
t值		0.214	5.945	0.543	5.242	0.133	4.820	0.362	9.018
P值		0.831	＜0.001	0.588	＜0.001	0.895	＜0.001	0.718	＜0.001

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