血清儿茶酚胺对手足口病重症病例的早期预警作用探讨

Early Warning Effect of Serum Catecholamine on Severe Cases of Hand-foot-and-mouth Disease

目的：探讨血清儿茶酚胺对手足口病重症病例的早期预警作用。方法：选择本院儿科2013年9月-2015年12月收住院的165例0-5岁诊断为手足口病儿童为试验组，50例0-5岁健康儿童为对照组。试验组分为普通1组（n=58）、普通2组（n=56）、重症。2期组（n=49）、重症3期组（n=37）、重症4期组（n=21），普通2组在治疗过程中转为重症，25例转为2期，22例转为3期，9例转为4期。测定研究对象血清儿茶酚胺浓度、葡萄糖（GLU）浓度。结果：普通1组血清儿茶酚胺浓度与对照组比较，差异均无统计学意义（P〉0．05），普通2组显著高于普通1组和重症2期组（P〈0．001），重症3期组显著高于重症2期组（P〈0．001），重症4期组显著高于重症3期组（P〈0．001），重症2期组去甲肾上腺素（NE）、多巴胺（DA）浓度显著高于普通1组（P〈0．001），肾上腺素（E）浓度与普通1组比较差异无统计学意义（P〉0．05）。普通1组、对照组的儿茶酚胺浓度与GLU浓度不相关，普通2组儿茶酚胺浓度与GLU浓度呈显著正相关，重症2期组E浓度与GLU浓度不相关，NE、DA浓度与GLU浓度显著正相关，重症3期组、重症4期组的儿茶酚胺浓度与GLU浓度显著正相关。结论：手足口病儿童血清儿茶酚胺浓度与病情有密切的关系，NE、DA浓度变化较E早，在潜在重症病例或重症病例与血清GLU浓度呈显著的正相关，痈隋越重浓度越高，可作为重症病例的早期预警指标。

Objective：To investigate the effect of serum catecholamine on early warning of severe cases of Hand-foot-and-mouth disease.Method：One hundred and sixty-five Hand-foot-and-mouth disease patients were selected as the experimental group at the age of five participated in this study.They were admitted to ourhospital from September 2013 to December 2015.Fifty Outpatients physical health at the age of five acted were selected as the control group.The experimental group was divided into ordinary group 1（n=58）,ordinary group 2（n=56）,severe phase 2 group（n=49）,severe phase 3 group（n=37） and severe phase 4 group（n=21）.Patients of ordinary 2 group in the treatment process transferred to severe cases,twenty-five,twenty-two and nine cases of who to severe phase 2, 3 and 4.The concentration of catecholamine and glucose of all study subjects were determined.Result：There was no significant difference between ordinary group 1 and the control group in the concentration of serum catecholamine（P〉0.05）.The concentration of serum catecholamine in ordinary group 2 was significantly higher than that of ordinary group 1（P〈0.001）.The concentration of serum catecholamine in ordinary group 2 was significantly higher than that of ordinary group 1 and severe phase 2 group（P〈0.001）.Severe phase 3 group was significantly higher than that of severe phase 2 group（P〈0.001）.Severe phase 4 group was significantly higher than that of severe phase 3 group（P〈0.001）.The concentration of serum NE and DA in severe phase 2 group were significantly higher than those of ordinary group 1（P〈0.001）.The serum E was no significant difference between severe phase 2 group and ordinary group 1（P〉0.05）.The concentration of catecholamine was not related with GLU in ordinary group 1 and the control group.The serum catecholamine in ordinary group 2 was significantly positively correlated with GLU.The serum E was not related to GLU in severe phase 2 group,but NE and DA were significantly positively correlated with GLU.The catecholamine in severe phase 3 group and severe phase 4 group were significantly positively correlated with GLU.Conclusion：The level of serum catecholamine in children with Hand-foot-and-mouth disease is closely related to the disease.The concentration change of DA and NE are earlier than that of E.Significant positive correlation is showed between the concentration of catecholamine and GLU in potential severe cases or severe cases.The higher the severity of the disease,the higher the concentration.Serum catecholamine can be used as early warning indicators of severe cases of Hand-foot-and-mouth disease.