手足口病患儿血清降钙素原、C反应蛋白、白介素-6及白介素-10检测的意义

Significance of detection of serum procalcitonin,C reactive protein,interleukin-6 and interleukin-10 in children with hand-foot-and-mouth disease

目的通过检测手足口病(HFMD)患儿血清降钙素原(PCT)、C反应蛋白(CRP)、白介素-6(IL-6)及白介素-10(IL-10)水平,探讨其临床意义。方法采用电化学发光法检测126例HFMD患儿及30例正常对照儿童血清PCT水平;采用免疫速率散射比浊法检测126例患儿及30例正常儿童血清CRP水平;用酶联免疫吸附试验(ELISA)检测64例HFMD患儿及24例正常对照儿童的血清IL-6、IL-10水平。结果普通病例组的PCT浓度为0.054(0.035～0.080)ng/mL,重症病例组的PCT浓度为0.067(0.043～0.119)ng/mL,正常对照组为0.037(0.026～0.044)ng/mL,各组差异有统计学意义(H=26.678,P=0.000);普通病例组的CRP浓度为1.950(1.100～3.575)ng/mL,重症病例组的CRP浓度为2.450(1.100～12.075)ng/mL,正常对照组为1.600(1.075～2.550)ng/mL,重症病例组高于正常对照组(Z=-2.081,P=0.037);PCT、CRP、IL-6和IL-10重症病例组与普通病例组间差异无统计学意义(Z=-1.865,P=0.062;Z=-1.707,P=0.088;Z=-1.396,P=0.163;Z=-0.951,P=0.342);126例HFMD患儿中,PCT阳性率为60.32%,CRP阳性率为15.08%,PCT和CRP在HFMD患儿中阳性率均升高(P≤0.05),PCT阳性率明显高于CRP(P<0.001)。结论血清PCT可作为HFMD患儿炎症性参考指标,反映HFMD免疫性炎症改变。

Objective To detect the levels of serum procalcitonin（PCT）,CRP（C reactive protein）,IL-6 and IL-10 in children with hand-foot-and-mouth disease（HFMD） for the purpose of exploring their clinical significance.Methods the serum PCT levels of 126 HFMD children and 30 normal controls were detected by Electrochemical luminescence immunoassay,the CRP levels by Immunization rate nephelometry,and the levels of IL-6 and IL-10 in 64 HFMD children and 24 normal controls were analyzed by enzyme linked immunosorbent assay（ELISA）.Results The levels of PCT and CRP of ordinary cases were 0.054（0.035 to 0.080） ng/mL and 1.950（1.100 to 3.575） ng/mL,and those of severe cases were 0.067（0.043 to 0.119） ng/mL and 2.450（1.100 to 12.075） ng/mL,and those of normal control group were 0.037（0.026 to 0.044） ng/mL and 1.600（1.075 to 2.550） ng/mL.The PCT level of each group had statistical difference（H=26.678,P=0.000）,and CRP of severe cases was dramatically higher than that in normal control group（Z=-2.081,P=0.037）.The PCT,CRP,IL-6 and IL-10 of severe cases,compared with ordinary cases,showed no significant differences（Z=-1.865,P=0.062;Z=-1.707,P=0.088;Z=-1.396,P=0.163;Z=-0.951,P=0.342）.The positive rates of PCT and CRP were 60.32% and 15.08% respectively,and both of the positive rates were increased（P≤0.05）,with the positive rate of PCT higher than that of CRP（P0.001）.Conclusion Serum PCT can be used as a reference index of inflammation in HFMD and reflects the autoimmune inflammatory changes.