NT-proBNP、IFN-γ、NO在重症手足口病诊断及预后评估中的价值

Value of NT-proBNP, IFN-γ and NO in the diagnosis and prognosis evaluation of severe hand-foot-mouth disease

目的探讨氨基末端脑钠肽前体(NT-proBNP)、γ干扰素(IFN-γ)、一氧化氮(NO)在重症手足口病诊断和预后评估中的应用价值。方法选取手足口病患儿224例,根据病情分为轻症组和重症组,另选取同期健康儿童30例为对照组;重症组根据预后分为生存组和死亡组。比较各组血清NT-proBNP、IFN-γ、NO水平。采用ROC分析NT-proBNP、IFN-γ、NO对重症手足口病诊断和预后的预测价值。采用Logistic回归分析重症手足口病患儿预后的影响因素。结果重症组、轻症组、对照组血清NT-proBNP、IFN-γ、NO依次降低;死亡组血清NT-proBNP、IFN-γ、NO高于生存组(P<0.05)。死亡组血氧饱和度<90%者死亡率高于血氧饱和度≥90%者。血清NT-proBNP、IFN-γ、NO联合检测对重症手足口病诊断和预后均具有良好的预测价值(P<0.05)。血清NT-proBNP、IFN-γ、NO高表达是重症手足口病患儿不良预后的危险因素,血氧饱和度<90%是预后良好的保护因素。结论重症手足口病患儿血清NT-proBNP、IFN-γ、NO水平升高,联合检测对其诊断和预后评估具有重要价值。

Aim To explore the application value of N-terminal pro-brain natriuretic peptide(NT-proBNP),interferon-γ(IFN-γ)and nitric oxide(NO)in the diagnosis and prognosis evaluation of severe hand-foot-mouth disease.Methods A total of 224 children with hand-foot-mouth disease were enrolled.According to disease severity,they were divided into mild group and severe group.A total of 30 healthy children during the same period were enrolled as control group.According to prognosis results,children in severe group were divided into survival group and death group.The levels of serum NT-proBNP,IFN-γand NO in different groups were compared.The value of NT-proBNP,IFN-γand NO in the diagnosis and prognosis prediction of severe hand-foot-mouth disease was analyzed by ROC curves.Using Logistic regression to analyze the influencing factors of prognosis for severe hand,foot,and mouth disease.Results The levels of serum NT-proBNP,IFN-γand NO were gradually decreased in severe group,mild group and control group.The levels of serum NT-proBNP,IFN-γand NO in death group were higher than those in survival group(P<0.05).In death group,death rate in patients with oxygen saturation<90%was higher than that of patients with oxygen saturation≥90%.The combined detection of serum NT-proBNP,IFN-γand NO was of good value in the diagnosis and prognosis prediction of severe hand-foot-mouth disease(P<0.05).The high expressions of serum NT-proBNP,IFN-γand NO are risk factors of poor prognosis in children with severe HFMD,while oxygen saturation<90%was a protective factor of good prognosis.Conclusion The levels of serum NT-proBNP,IFN-γand NO are increased in children with severe HFMD,and combined detection of the three indexes is of great value in the diagnosis and prognosis evaluation of HFMD.