不同临床分期手足口病患儿血清 TNF 、IL-6及 BNP 变化及临床意义

Changes of Cytokines and B-type Natriuretic Peptide in Serum of Children with Hand,Foot and Mouth Disease at Different Stage

【目的】探讨手足口病不同临床分期（1、2、3、4期）肿瘤坏死因子（tumor necrosis factor ，TNF）、白介素-6（IL-6）及B型脑钠肽（BNP）的变化特点，为临床评估此类患者提供参考。【方法】选择2011年5月至2013年10月在本院就诊的手足口病患儿292例（其中1期156例，2期106例，3期20例，4期10例），于患儿入院24 h内抽血行TNF、IL-6、BNP检测。观察比较不同分期手足口病患儿细胞因子及BNP的变化特点。【结果】各期TNF、IL-6、BNP水平均较健康对照组明显增高，2期、3期患儿TNF、IL-6、BNP水平明显高于1期，4期的TNF、IL-6、BNP水平明显高于2期、3期水平，且差异相比较均有显著性（ P ＜0．05）。2、3期TNF、IL-6、BNP水平相比较差异无显著性（ P ＞0．05）。【结论】随着患儿病情加重，TNF、IL-6及BNP水平随之相应增高，TNF、IL-6及BN P水平可用于手足口病患儿病情评估的参考指标。

Objective To explore the changes of cytokines tumor necrosis factor （TNF） ,interleukin-6（IL-6） and B-type natriuretic peptide BNP in children with different stages of hand ,foot and mouth disease in order to provide the reference for clinical evaluation of the patients .[Methods]Totally 292 patients with different stages of hand ,foot and mouth disease in our hospital from May 2011 to Oct .2013 were chosen .There were 156 children in stage 1 ,and 106 children in stage 2 ,and 20 children in stage 3 and 10 children in stage 4 .Blood was drawn within 24h after admission .TNF ,IL-6 and BNP were determined .The changes of cytokines and BNP in children with different stages of hand ,foot and mouth disease were observed and compared .[Results]Compared with healthy control group ,the levels of TNF ,IL-6 and BNP in different stage were increased obviously .The levels of TNF ,IL-6 and BNP of patients in stage 2 and stage 3 were obviously higher than those in stage 1 ,and those in stage 4 were obviously higher than those in stage 2 and stage 3 ,and there was significant difference （ P〈0 .05） .There was no significant difference in the levels of TNF ,IL-6 and BNP b-tween stage 2 and stage 3（ P〉0 .05） .[Conclusion]The levels of TNF ,IL-6 and BNP increase with the severity of pediatric patients . The levels of TNF ,IL-6 and BNP can be used as the reference indexes for evaluating the condition of patients with hand ,foot and mouth disease .