HFMD患儿血浆及脑脊液神经元特异性烯醇化酶水平及意义

Significance of neuron specific enolase level in plasma and cerebrospinal fluid in children with severe HFMD

目的观察重症手足口病患儿血浆及脑脊液中神经元特异性烯醇化酶（NSE）水平,并探讨其临床意义。方法选择于2013年1月-12月收治住院的手足口病患儿78例作为研究对象,根据严重程度分为为重症组35例、轻度组43例,测定两组患儿治疗前后血浆及脑脊液神经元特异性烯醇化酶水平,并进行比较分析。结果重症组治疗前血浆、脑脊液NSE水平分别为（24.8±5.1）μg/L、（33.5±6.7）μg/L,均显著高于轻度组（P〈0.05）。治疗后,两组血浆、脑脊液NSE水平无明显统计学差异（P〉0.05）。重症组脑电图异常、MRI异常分别为27例（77.1%）和21例（60.0%）,均高于轻度组（P〈0.05）;治疗后CSF阴转率重症组低于轻度组（P〈0.05）;住院时间重症组长于轻度组（P〈0.05）。结论重症手足口病患儿血浆及脑脊液中神经元特异性烯醇化酶水平较高,测定其水平有助于手足口病病情严重程度评估,具有临床指导价值。

Objective To investigate level of neuron specific euolase （NSE） in plasma and cerebrospinal fluid （CSF） of children with severe hand-foot-mouth disease, and explore its clinical significance. Methods The seventy-eight patients with hand-foot -mouth disease in Longgang Central Hospital in 2013 were divided into severe group （35 cases） and mild group （43 cases）.The level of neuron specific enolase in plasma and CSF before and after treatment were detected and compared between two groups. Results NSE levels in plasma and CSF in severe group before treatment were （24.8 ±5.1）μg/L and （33.5 ± 6.7）μg/L , respectively, which were significandy higher than that in mild group （P〈0.05）. There was no significant difference in NSE levels in plasma and CSF after treatment between two groups （P〉0.05）. There found 27 EEG abnormality cases （77.1%）, 21 abnormal MRI cases （60.0%） in the severe group, which was higher than that in the mild group （P〈0.05）. After treatment, CSF negative conversion rate in severe group was lower than that in mild group （P〈0.05）; hospitalization time in severe group was longer than that of mild group （P〈0.05）. Conclusion NSE levels in plasma and CSF in children with severe hand-foot -mouth disease was relative higher. Determination of NSE levels contributed to assess severity of hand-foot - mouth disease, which had important clinical guidance value.