血清高迁移率族蛋白1和神经胶质纤维酸性蛋白水平预测手足口病严重程度的价值

Significance of serum level of HMGB-1 and glial fibrillary acidic protein in predicting the severity of hand-foot-mouth disease

目的探讨手足口病患儿血清高迁移率族蛋白1(HMGB-1)和血清神经胶质纤维酸性蛋白(GFAP)水平检测对其病情严重程度的预测价值。方法选取手足口病患儿60例(手足口病组)。另选取30例体检健康儿童为对照组。酶联免疫吸附法(ELISA)检测两组血清HMGB-1、GFAP和S100B蛋白(S100B protein,S100B)水平。依据小儿危重病例量表(PCIS)对患儿进行病情危重程度评分。比较两组血清HMGB-1、GFAP和S100B水平。比较普通型和重型患儿血清HMGB-1、GFAP和S100B及PCIS评分。比较重症患儿治疗前后血清HMGB-1、GFAP和S100B水平及PCIS评分及血清中白细胞介素(IL)-6和肿瘤坏死因子(TNF)-α水平。Pearson直线相关分析手足口病患儿血清HMGB-1、GFAP和S100B水平与PCIS评分及血清IL-6和TNF-α水平的相关性。结果与对照组比较,手足口病组患儿血清HMGB-1、GFAP和S100B水平明显升高(P <0. 01)。重型患儿血清HMGB-1、GFAP和S100B水平明显高于普通型患儿,PCIS评分明显低于普通型患儿(P <0. 01)。危重型患儿血清HMGB-1、GFAP和S100B水平明显高于普通型和重型患儿,而PCIS评分明显低于普通型和重型患儿(P <0. 01)。与治疗前比较,重型和危重型患儿治疗后血清HMGB-1、GFAP和S100B水平明显下降,PCIS评分明显升高(P <0. 01)。治疗后,重型患儿血清中IL-6和TNF-α水平均明显降低(P <0. 01)。Pearson相关系数分析血清HMGB-1、GFAP和S100B水平与PCIS评分间呈明显负相关(r=-0. 644、-0. 628、-0. 629,P <0. 01),与血清中IL-6和TNF-α水平呈显著正相关(r=7. 222、0. 712、0. 713; r=6. 675、0. 689、0. 690; P <0. 01)。结论血清HMGB-1、GFAP和S100B水平是临床评价手足口病患儿病情严重程度及治疗效果的有效指标。

Objective To investigate the value of serum level of high mobility group protein 1(HMGB -1)and glial fibrillary acidic protein (GFAP)in predicting the severity degree of hand-foot -mouth disease.Methods Sixty hand-foot-mouth disease cases (hand-foot-mouth disease group)in our hospital were selected.Thirty healthy children were randomly chosen as the control group.Double antibody sandwich enzyme-linked immunosorbent assay (ELISA)was employed to detect serum levels of HMGB -1,GFAP and S100B in two groups.The severity was evaluated by pediatric critical cases scale (PCIS).Serum levels of HMGB-1,GFAP and S100B were compared between the two groups.Serum level of HMGB-1,GFAP and S100B,and PCIS score were compared in the critical type group and the common type.Serum levels of HMGB-1,GFAP and S100B,and PCIS score and serum levels of IL -6 and TNF-α in the critical group were compared before and after treatment.Pearson linear correlation analysis was used to analyze the correlations between serum levels of HMGB-1,GFAP and S100B,and PCIS score or serum levels of IL-6 and TNF-α. Results Compared to control group,serum levels:of HMGB-1,GFAP and S100B were significantly higher (P < 0.01).Serum levels of HMGB -1,GFAP and S100B of the severe type group was significantly higher,while PCIS score was significantly lower,than the common type (P <0.01).Serum levels of HMGB-1,GFAP and S100B of the critical type group was obviously higher,while PCIS score was lower,than severe type group (P <0.01).The critical type and severe type groups had significant reductions in serum levels of HMGB-1,GFAP and S100B after treatment (P <0.01). After treatment,serum levels of IL -6and TNF-α of the critical type and severe type groups were remarkably decreased (P <0.01).Pearson linear correlation analysis showed that serum levels of HMGB-1,GFAP and S100B were significantly negatively correlated with PCIS score;and positively correlated with serum levels of IL -6 and TNF-α (P <0.01).Conclusion The serum levels of HMGB-1,GFAP and S100B are effective indexes predicting the severity and treatment outcomes of hand -foot -mouth disease.