手足口病继发细菌感染患儿血炎症指标水平变化研究

Changes of levels of blood inflammatory indexes in hand,foot,and mouth disease children with secondary bacterial infection

目的探讨手足口病继发细菌感染患儿血炎症指标水平变化,为临床诊治提供参考。方法收集2013年6月-2015年6月在医院住院治疗的单纯手足口病患者及手足口病继发细菌感染患者共100例,分为继发感染组与无感染组,各50例,两组均在入院后及应用抗菌药物治疗前检测血白细胞计数(WBC)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、降钙素原(PCT),分析结果。结果继发感染组患儿血WBC、IL-6、PCT均高于无感染组(P<0.05),CRP比较差异无统计学意义;继发感染组血WBC、CRP、IL-6、PCT阳性率分别为86.00%、82.00%、84.00%、94.00%,高于无感染组,比较差异有统计学意义(P<0.05);血WBC诊断手足口病继发细菌感染的敏感度、特异度分别为86.00%、52.00%,CRP分别为82.00%、36.00%,IL-6分别为84.00%、40.00%,PCT分别为94.00%、98.00%。结论手足口病继发细菌感染时患儿血WBC、CRP、IL-6、PCT等炎症指标均明显升高,PCT相对于其他指标用于诊断手足口病继发细菌感染敏感度及特异度均最高,可用于继发细菌感染的诊断及指导治疗。

OBJECTIVE To explore the changes of levels of blood inflammatory indexes in hand ,foot ,and mouth disease children with secondary bacterial infection so as to provide guidance for clinical diagnosis and treatment . METHODS A total of 100 patients with single hand ,foot ,and mouth disease and hand ,foot ,and mouth disease patients with secondary bacterial infection who were hospitalized for treatment from Jun 2013 to Jun 2015 were en‐rolled in the study and divided into the secondary infection group and the non‐infection group ,with 50 cases in each group .The white blood cell （WBC） counts and the levels of C‐reactive protein （CRP） ,interleukin‐6 （IL‐6） , and procalcitonin （PCT） of the two groups were determined after the admission to hospital and before the antibiot‐ic therapy ;the results were observed .RESULTS The levels of blood WBC ,IL‐6 ,and PCT of the secondary infec‐tion group were higher than those of the non‐infection group （P〈0 .05） ,however ,there was no significant differ‐ence in the level of CRP .The positive rates of the blood WBC ,CRP ,IL‐6 ,and PCT of the secondary infection group were 86 .00% ,82 .00% ,84 .00% ,and 94 .00% ,respectively ,higher than those of the non‐infection group , and there was significant difference （P〈0 .05） .The sensitivities of the blood WBC ,CRP ,IL‐6 ,and PCT in diag‐nosis of the hand ,foot ,and mouth disease with secondary bacterial infection were 86 .00% ,82 .00% ,84 .00% , and 94 .00% ,respectively ;the specificities of the blood WBC ,CRP ,IL‐6 ,and PCT in diagnosis of the hand , foot ,and mouth disease with secondary bacterial infection were 52 .00% ,36 .00% ,40 .00% ,and 98 .00% ,re‐spectively .CONCLUSION The levels of blood WBC ,CRP ,IL‐6 ,and PCT of the hand ,foot ,and mouth disease children with secondary bacterial infection are remarkably elevated .As compared with other indexes ,the PCT had the highest sensitivity and specificity in diagnosis of the hand ,foot ,and mouth disease with secondary bacterial in‐fection ,and it can be used for the diagnosis and guiding treatment of the secondary bacterial infection .