Investigation of infants/toddlers wheezing affected by the hand foot and mouth disease

Abstract

Objective To investigate the relationship between the severity of infant/toddlers wheezing and hand,foot and mouth disease (HFMD) infection.Methods We selected infant/toddlers wheezing with HFMD cases in respiratory department of our hospital from January 2010 to January 2012,and 30 cases of enterovirus 71 (EV71) were selected as the experimental group and 30 cases of coxsackie virus A type 16 (CA16)as the control group,respectively,according to HFMD pathogen infection.Wheezing cases by severity were divided into intermittent stares with mild persistent group (A) and moderate and severe persistent group (B).HFMD by severity were divided into ordinary and severe cases group.Wheezing severity before and after HFMD,relationship between HFMD severity and wheezing severity and the content of serum cytokines such as interferon-γ(IFN-γ) and interleukin-4 (IL-4) were compared between EV71 group and CA16 group,and statistical analysis was performed.Results (1) Wheezing severity(A,B) corresponding cases:EV71 group(25,5),(5,25),and CA16 group(24,6),(15,15) before and after HFMD.The case-constituent ratio in EV71 and CA16 same group was compared before and after infection,and the differences were statistically significant(P ＜ 0.05).The differences in EV71 group and CA16 group were not statistically significant (x2 =0.11,P ＞ 0.05)before infection,and were statistically significant(x2 =7.50,P ＜0.05) after infection.(2) Severe cases,ordinary group and severe wheezing (A,B) corresponding cases:(17,1),(32,10) before infection,and (2,16),(18,24) after infection.The upgrade cases constituent ratio of wheezing severity after infection were compared between severe and ordinary cases group,and the difference was statistically significant (x2 =5.88,P ＜ 0.05).(3) The content of serum cytokines as IFN-γand IL-4 and IFN-γ/IL-4 ratio were compared in EV7l group and CA16 group before and after infection,and the differences were statistically significant (P ＜ 0.001) ; and the differences compared in EV71 group and CA16 group were not statistically significant(P ＞0.05) before infection and statistically significant(P ＜ 0.05) after infection.Conclusions Infant/toddlers wheezing with HFMD and wheezing severity of severe disease and EV7l infections were exacerbated trend in the short term after infection.The infection of EV71 may promote Th1/Th2 drift. Key words: Infant/toddler; Wheezing; Hand,foot and mouth disease; Cytokines