感染指标在手足口病早期合并细菌感染的诊断价值

Value of infection indicators in early diagnosis of hand,foot and mouth disease with bacterial infection

目的:探讨血清白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、白细胞计数(WBC)、C-反应蛋白(CRP)、降钙素原(PCT)水平对手足口病早期合并细菌感染患儿的临床诊断价值。方法 :细菌感染组63例,单纯病毒感染组63例,同时收集健康体检儿童63例,采用酶联免疫吸附试验(ELISA)双抗体夹心法测定血清IL-6、IL-10,免疫比浊法检测血清CRP,酶联荧光法检测血清PCT,收集相应WBC结果,并进行比较分析。结果:经检测单纯病毒感染组患儿血清IL-6、IL-10、CRP、PCT水平均高于正常对照组水平,WBC水平稍低于正常对照组,其中IL-6、IL-10、CRP差异有统计学意义(P<0.05);合并细菌感染组血清IL-6、IL-10、WBC、CRP、PCT水平均高于单纯病毒感染组和正常对照组水平,与单纯病毒感染组比较,血清WBC、CRP、PCT水平差异有统计学意义(P<0.05);IL-6、IL-10差异无统计学意义(P>0.05)。结论 :IL-6、IL-10水平在手足口病早期明显升高,但在合并细菌感染和单纯细菌感染鉴别方面临床价值不显著;WBC、CRP、PCT水平对于鉴别手足口病早期是否合并细菌感染具有重要价值。

Objective To explore serum IL-6（interleukin-6）,IL-10（interleukin-10）, the WBC（white blood cell count）, CRP（C-reactive protein）and PCT（ procalcitonin） level in early diagnosing of in children with hand, foot and mouth disease and bacterial infection. Methods 63 children in bacterial infection group and virus infection group respectively,collected 63 children in normal control group by physical examination.Enzyme-linked immunosorbent assay（ELISA） double antibody clamp method was used to determine serum IL-6and IL-10 level. Immune turbidimetric, enzyme-linked fluorescent were used to detected serum CRP, PCT. WBC results were also compared. Resluts Serum IL-6, IL-10, CRP and PCT level were higher in normal control group compared with virus infection group, the WBC level was slightly lower than normal control grou with statistically different IL-6, IL-10, CRP level（P〈0.05）;serum IL-6, IL-10, WBC, CRP and PCT levels in Bacteria infection group were higher than virus infection group and normal control group, while their serum WBC, CRP and PCT level were statistically significant compared to virus infection group（P〈0.05）,IL-6 and IL-10 were no statistical different（P〉0.05）. Conclusion IL-6, IL-10 levels increased significantly in the early stage of hand,foot and mouth disease, but in the aspect of combination of bacterial infection and bacterial infection, their clinical value was not so significant. WBC, CRP and PCT level had important value for early diagnosis in hand, foot and mouth disease with bacterial infection.