手足口病患儿血清内毒素、D-乳酸和前降钙素水平检测的意义

Significance of detection of serum endotoxin,D-lactate and procalcitonin levels of children with Hand-Foot-Mouth Disease

目的探讨手足口病(HFMD)患儿血清内毒素、D-乳酸和前降钙素(PCT)水平检测的意义。方法选取HFMD患儿60例(观察组),根据病情轻重分为轻症组(n=32例)和重症组(n=28例)。观察组患儿均予以利巴韦林抗病毒、小儿退热栓退热及营养支持等常规基础治疗,连用5 d。观察并记录患者治疗前和治疗5 d后血清内毒素、D-乳酸和PCT水平的变化。另选择同期常规体检的健康儿童30例作对照(对照组)。结果观察组患者血清内毒素、D-乳酸和PCT水平明显高于对照组(P<0.01)。轻症组患儿血清内毒素、D-乳酸和PCT水平明显低于重症组(P<0.01)。治疗5 d后,观察组患者治疗后血清内毒素、D-乳酸和PCT水平较前明显下降(P<0.05)。结论 HFMD患儿存在血清内毒素、D-乳酸和PCT水平的异常上升,可见HFMD患儿发病早期就存在肠黏膜屏障功能损伤。内毒素、D-乳酸和PCT水平变化可作为HFMD患儿病情程度和疗效随访的敏感血清学指标。

Objective To discuss the significance of detection of serum endotoxin, D-lactate and procalcitonin （PCT） levels of children with Hand-Foot-Mouth Disease （HFMD）. Methods 60 children with HFMD were selected as the observation group and further divided into mild symptom group （ n = 32 cases） or severe symptom group （ n = 28 cases）. The children were given routine medical treatment such as ribavirin, Paraeetamol Supposito- ries and nutritional support ete for 5 days. The changes of serum endotoxin, D-lactate and PCT levels of the chil- dren before and after the treatment were observed. 30 healthy children who were accepting physical examination at the same time were selected as the controls （control group）. Results The serum endotoxin, D-lactate and PCT levels in observation group were obviously higher than those in control group （P 〈 0. 01 ）. The serum endotoxin, D- lactate and PCT levels in mild symptom group were obviously lower than those in severe symptom group （ P 〈 0. 01 ） . After 5 days＇ treatment, the serum endotoxin, D-lactate and PCT levels in observation group obviously declined than those before the treatment （P 〈0. 05）. Conclusion The abnormal rising of serum endotoxin, D-lactate and PCT levels of children with HFMD indicates the damage of intestinal mueosal barrier function. The changes of serum endotoxin, D-lactate and PCT levels can be used as the serological indexes of the condition progress and efficacy follow-up of children with HFMD.