血清心型脂肪酸结合蛋白检测在手足口病患儿心肌损伤中的诊断意义

The diagnostic value of heart fat acid binding protein in myocardial damage of children with hand-foot-mouth disease

目的研究血清心型脂肪酸结合蛋白(h-FABP)检测在手足口病(HFMD)患儿心肌损伤中的诊断意义。方法选取2012年2月至2014年12月期间本院收治的100例HFMD患儿作为观察组,根据病情将患儿分成两个亚组:普通型HFMD 71例,重症HFMD29例;选取同一时期的健康儿童作为对照组。比较各组儿童的血常规检查,心电图异常率、肌钙蛋白(cTnI)和hFABP异常率。比较普通型HFMD亚组和重症HFMD亚组不同时刻的cTnI和h-FABP。结果各组儿童的RBC、WBC和L具有统计学差异(P<0.05);PLT无统计学差异(P>0.05)。普通型HFMD亚组心电图异常率19.72%(14/71),cTnI异常率4.23%(3/71),h-FABP异常率16.39%(10/71);重型HFMD亚组心电图异常率72.41%(21/29),cTnI异常率82.76%(23/29),h-FABP异常率82.96%(23/29);对照组心电图异常率1.00%(1/100),cTnI异常率2.00%(2/100),h-FABP异常率0.00%(0/100),差异具有统计学意义(P<0.05)。普通型HFMD亚组和重症HFMD亚组不同时刻的cTnI和h-FABP差异具有统计学意义(P<0.05)。结论心型脂肪酸结合蛋白可以反应HFMD患儿早期的心肌损伤。

Objective To study the diagnostic value of heart fat acid binding protein（h-FABP）in myocardial damage of children with hand-foot-mouth disease（HFMD）.Methods From February 2012 to December 2014,100 children with HFMD were chosen as study objects.All children study were divided into 2sub-groups according to the severity of disease：71in ordinary HFMD subgroup,29 in severe HFMD sub-group.At the same time,100 healthy children were chosen as control group.The routine blood test,rate of abnormal electrocardiography,rate of abnormal cTnI and rate of abnormal h-FABP were compared among all children.The cTnI and h-FABP at different time were compared between ordinary HFMD sub-group and severe HFMD sub-group.Results The WBC,RBC and L had significant difference among different groups/sub-groups（P〈0.05）,the difference of PLT had no statistical significance（P〉0.05）.In ordinary HFMD sub-group,rate of abnormal electrocardiography was 19.72%（14/71）,rate of abnormal cTnI was 4.23%（3/71）and rate of abnormal h-FABP was16.39%（10/71）;in severe HFMD group,rate of abnormal electrocardiography was 72.41%（21/29）,rate of abnormal cTnI was 82.76%（23/29）and rate of abnormal h-FABP was 82.96%（23/29）;in control group,rate of abnormal electrocardiography was 1.00%（1/100）,rate of abnormal cTnI was 2.00%（2/100）and rate of abnormal h-FABP was 0.00%（0/100）,the difference had statistical significance（P〈0.05）.The cTnI and h-FABP at different time had significant difference between ordinary HFMD sub-group and severe HFMD sub-group（P〈0.05）.Conclusion Heart fat acid binding protein（h-FABP）can reflect the early myocardial damage in children with hand-foot-mouth disease.