重症手足口病患儿血糖和脑脊液检测的临床意义

Significance of detection of blood glucose,peripheral white blood cell and cerebrospinal fluid in children with servere hand-foot-mouth disease

目的对重症及危重症手足口病患儿血糖和外周血白细胞以及脑脊液的变化特点进行研究分析。方法回顾性分析91例重症及危重症手足口病患儿入院后血糖、外周血白细胞以及脑脊液白细胞计数和生化检查的临床资料。结果危重症病例组患儿外周血白细胞、血糖明显高于重症病例组,差异有统计学意义(P<0.01)。重症病例患儿脑脊液白细胞增高,危重症病例明显增高,差异有统计学意义(P<0.01)。51例重症病例组蛋白超标9例,最高为0.71g/L,40例危重症病例组蛋白超标11例,最高为0.95g/L,两组之间比较,差异有统计学意义(P<0.05)。重症患儿脑脊液葡萄糖正常,危重症病例脑脊液葡萄糖升高,两者差异有统计学意义(P<0.01)。结论对有重症及危重症倾向的手足口病患儿进行常规血糖、外周血白细胞和脑脊液检查,有利于重症及危重症的早期诊断、及时治疗,降低死亡率。

Objective To investigate the changes and clinical characteristics of blood glucose, peripheral white blood cell（WBC） and cerebrospinal fluid（CSF） in the children with severe critical hand, foot and mouth disease（HFMD）. Methods The levels of blood glucose, peripheral WBC and CSF leukocyte count and biochemical examination of 91 cases with severe critical HFMD were analyzed retrospectively. Results The levels of blood glucose and peripheral WBC in critical severe HFMD children were significantly increased compared with severe HFMD children demonstrated a significant difference（P〈0.01）.The levels of CSF leukocyte in critical HFMD children were high,but higher in critical severe HFMD children,which demonstrated a significant difference （P〈0.01）. Thirdly, the levels of CSF protein in 9 of the 51 severe HFMD cases were high and the highest was 0.71g/L.The levels of CSF protein of 11 cases of 40 critical severe HFMD were high and the highest was 0.95g/L showing a significant difference （P〈0.05） between the two groups. Fourthly, the levels of CSF glucose of severe HFMD children was normal, and the levels of CSF glucose of critical severe HFMD children was high, demonstrated a significant difference （P〈0.01）. Conclusion The examination of the blood glucose, peripheral WBC and CSF in the children tendency to critical and severe HFMD should be advantageous to early diagnosis of the critical and severe, timely treatment and lower mortality.