血清BNP、NSE及VCAM-1对手足口病患儿并发脑炎的诊断价值

Diagnosis value of serum BNP,NSE and VCAM-1 in children with hand-foot and mouth disease complicating encephalitis

目的探讨血清脑钠肽(BNP)、神经特异性烯醇化酶(NSE)及血管细胞黏附分子-1(VCAM-1)对手足口病(HFMD)患儿并发脑炎的诊断价值。方法以49例普通HFMD患儿为HFMD组,46例HFMD继发脑炎患儿为观察组,30例正常儿童为健康组。观察三组受试儿童血清BNP、NSE及VCAM-1水平差异,研究血清BNP、NSE及VCAM-1检测对HFMD患儿继发脑炎的诊断价值,分析HFMD继发脑炎患儿血清BNP、NSE及VCAM-1之间的相关性。结果观察组患儿血清BNP、NSE及VCAM-1水平明显高于HFMD组和健康组,而HFMD组患儿血清各指标又高于健康组(P<0.05)。观察组中随着患儿脑炎病情的加重,血清BNP、NSE及VCAM-1水平显著升高(P<0.05)。分别以BNP>18.93ng/L、NSE>17.23μg/L、VCAM-1>14.45μg/L为诊断HFMD患儿继发脑炎的临界值,三者诊断敏感度分别为76.1%、65.2%、67.4%;特异度分别为83.7%、89.8%、85.7%。HFMD继发脑炎患儿血清BNP、NSE及VCAM-1之间均呈显著正相关(P<0.05)。结论 HFMD继发脑炎患儿血清BNP、NSE及VCAM-1均明显升高,血BNP、NSE及VCAM-1检测有助于HFMD患儿继发脑炎的诊断和病情判断。

Objective To explore the diagnosis value of serum brain natriuretic peptide(BNP),neurone specific enolase(NSE)and vascular cell adhesion molecule-1(VCAM-1)in children with hand-foot and mouth disease(HFMD)complicating encephalitis.Methods 49 children with common HFMD were HFMD group,46 children with HFMD complicating encephalitis were observation group and 30 healthy children were healthy group.The differences of serum BNP,NSE and VCAM-1level were observed in three groups.The diagnosis values of BNP,NSE and VCAM-1in children with hand-foot and mouth disease complicating encephalitis were studied.The correlations between BNP,NSE and VCAM-1in patients with HFMD complicating encephalitis were analyzed.Results The levels of serum BNP,NSE and VCAM-1in observation group were significantly higher than HFMD group and healthy group,while those indexes in HFMD group were significantly higher than healthy group(P<0.05).As the disease progresses,the levels of serum BNP,NSE and VCAM-1also increased significantly(P<0.05).Take BNP>18.93ng/L,NSE>17.23μg/L,VCAM-1>14.45μg/L as critical value,the diagnostic sensitivities of three indexes were 76.1%,65.2%,67.4%and specificities were 83.7%,89.8%,85.7%.There were significant positive correlations between BNP,NSE and VCAM-1(P<0.05).Conclusion The levels of serum BNP,NSE and VCAM-1are significant increase in children with HFMD complicating encephalitis.The detection of serum BNP,NSE and VCAM-1is helpful for diagnosis of secondary encephalitis in children with HFMD and condition judgement.