血清NSE在手足口病患儿神经系统受累早期诊断的意义

Significance of Serum Neuron-Specific Enolase Levels in Early Diagnosis of Nervous System Damage in Patients with Hand-Foot-Mouth Disease

目的测定手足口病(HFMD)患儿血清神经元特异性烯醇化酶(NSE)水平,为了解本病中枢神经系统损害提供科学依据。方法 2012年4～5月住院的手足口病患儿54例,按照入院时有无神经系统受累表现分为神经系统受累组和神经系统未受累组,检测两组患儿血中的NSE水平,并观察神经系统未受累组患儿是否出现神经系统受累表现。结果 33例神经系统受累组手足口病患儿血NSE水平为(55.68±33.36)ng/ml,21例神经系统未受累组为(38.41±13.61)ng/ml,两组比较差异有统计学意义(P<0.05);21例神经系统未受累组有7例入院后出现神经系统受累表现,入院后出现神经系统受累组NSE(53.73±10.52)ng/ml,一直无神经系统受累表现组(30.75±5.79)ng/ml,两者差异有统计学意义(P<0.01)。结论手足口病患儿血NSE水平升高,提示手足口病患儿中枢神经系统受累,且NSE增高早于神经受累临床表现出现,对早期诊断有指导意义。

Objective To detect the concentration of neuron-specific enolase （NSE） in blood of patients with hand- foot- mouth disease （HFMD） and provide scientific basis for understanding the central nervous system damage in the disease. Methods All 54 hospitalized children with HFMD were investigated from April to May in 2012. According to the nervous system performance at admission, they were divided into the nervous system involvement group（ group A ,33 cases） and the nervous sys- tem has not affected group（ group B ,21 cases）. The concentration of NSE in the blood serum in all patients of two groups was tested. The damage of central nervous system was observed in group B. Results The levels of NSE were （55.68 ±- 33.36） ng/ml in group A and （38.41 ± 13.61 ） ng/ml in group B, the difference was statistical significant （P 〈 0.05 ）. 7 of 21 cases in the group B appeared nervous system involvement after admission, and their levels of NSE were（53.73 ± 10.52） ng/ml;while other 14 cases without nervous system involvement had lower levels of NSE （30.75 ± 5.79 ） ng/ml, and the difference was significant between them （P 〈 0.01 ）. Conclusion The NSE level may increase in HFMD patients, and promotes the involvement of central nervous system get. The elevated NSE levels can be detected prior to clinical performance, and should play an important role in the early diagnosis of nervous system involvement in HFMD.