联合血乳酸和降钙素原及血糖评估重症手足口病患儿预后的临床研究

The clinical study on blood lactic acid,procalcitonin and blood sugar for evaluation of the prognosis of severe hand- foot- and- mouth disease

目的：探讨联合运用乳酸、降钙素原（PCT）和血糖水平变化评价重症手足口病患儿预后的价值。方法：50例住院重症手足口病患儿按照预后分为存活组和死亡组,对比两组患者早期乳酸、降钙素原、血糖、小儿危重病例评分（PCIS）,同时通过ROC曲线观察不同指标对预后的参考价值,并观察联合三种指标组（联合组）与非联合组间患者病死人数的差异。结果：两组患者三种指标和小儿危重病例评分比较,差异均有统计学意义（P〈0.05）。三种指标预测死亡结局的ROC曲线下面积为0.69~0.83。联合组与非联合组间患者死亡人数比较差异有统计学意义（χ2=5.216,P=0.044）。结论：联合检测乳酸、降钙素原和血糖可以对重症手足口病患儿进行预后评估。

Objective： To investigate value of blood lactic acid,procalcitonin（ PCT） and blood sugar for evaluation of the prognosis of severe hand- foot- and- mouth disease. Methods： According to prognosis,50 hospitalized children with hand-foot- and- mouth diseasedivided into survival group and death group. The levels of blood lactic acid,procalcitonin and blood sugar and pediatric critical illness score（ PCIS） was compared in two groups,while ROC curve was observed by different prognostic indicators reference value,and to observe the three joint index group（ combination group） difference between the number of patients died of non- combination group. Results： There were significant differences between the two groups（ P 0. 05）in the three indicators and pediatric critical illness score. Area under the ROC curve ending three predictor of death in 0. 69 ~0. 83. Combination group was statistically significant（ χ2= 5. 216,P = 0. 044） and non- combination group differences in patient deaths. Conclusion： Combined lactic acid,procalcitonin and glucose are good for prognosis evaluation of severe hand- foot- and- mouth disease.