血清乳酸含量与手足口病患儿神经损伤、心肌损伤程度的相关分析

Correlation analysis of serum lactic acid content and the degree of nerve injury and myocardial damage in children with hand-foot-mouth disease

目的探讨血清乳酸含量与手足口病患儿神经损伤、心肌损伤程度的相关性。方法收集2015年6月~2017年6月在本院接受住院治疗的37例手足口病并发脑炎患儿作为脑炎组,选取同期的58例单纯手足口病患儿作为单纯手足口病组。采用酶比色法测定血清中乳酸的含量,采用酶联免疫吸附法(ELISA)测定神经损伤指标、炎症因子的含量,采用放射免疫法测定血清中心肌酶谱指标的含量。采用Pearson检验评估手足口病并发脑炎患儿血清乳酸含量与神经损伤严重程度、心肌酶谱指标的相关性。结果脑炎组患儿血清中的乳酸含量高于单纯手足口病组患儿(P<0.05),脑炎组患儿血清中的神经损伤指标神经特异性烯醇化酶(NSE)、S-100B蛋白(S-100B)、髓鞘碱性蛋白(MBP)含量显著高于单纯手足口病组(P<0.05),脑炎组患儿血清中的LDH、CK-MB、α-HBDH、AST含量高于单纯手足口病组患儿(P<0.05)。手足口病患儿血清中乳酸含量与神经损伤指标NSE、S-100B、MBP呈正相关(r=0.245、0.195、0.318,P<0.05);手足口病患儿血清中乳酸含量与心肌酶谱LDH、CK-MB、α-HBDH、AST呈正相关(r=0.275、0.415、0.512、0.198,P<0.05)。结论手足口病患儿随血清乳酸含量增高,其神经损害指标和心肌损害指标也明显增高,呈正相关,因此,血清乳酸含量可以做为手足口病神经损害和心肌损伤的一个预测指标。

Objective To investigate the correlation between serum lactic acid content and the degree of nerve injury and myocardial damage in children with hand-foot-mouth disease.Methods From June 2015 to June 2017,37 children with hand-foot-mouth disease complicated with encephalitis were enrolled as the encephalitis group.The other 58 children only with hand-foot-mouth disease at the same time were selected as the simple hand-foot-mouth disease group. The content of lactic acid in serum was determined by enzyme colorimetric method.The indexes of nerve injury and content of inflammatory factors were determined by enzyme linked immunosorbent assay （ELISA）.The content of myocardial enzymes in serum was determined by radioimmunoassay.Pearson test was used to evaluate the correlation between serum lactic acid content and severity of nerve injury in children with hand-foot-mouth disease complicated with encephalitis.Results The content of lactic acid in children in the encephalitis group was higher than that in the simple hand-foot-mouth disease group （P〈0.05）.The contents of neuron specific enolase （NSE）,S-100B protein （S-100B）,and myelin basic protein （MBP） in the encephalitis group were significantly higher than those in the simple hand-footmouth disease group （P〈0.05）.Meanwhile,the levels of serum LDH,CK-MB,α-HBDH,and AST in children in the encephalitis group were higher than those in children in the simple hand-foot-mouth disease group （P〈0.05）.The serum lactate content in children with hand foot and mouth disease is positively correlated with the nerve damage index NSE, S-100B and MBP （r=0.245,0.195,0.318,P〈0.05）.The serum lactate content in children with hand foot and mouth disease is positively correlated with myocardial enzyme spectrum LDH,CK-MB,α-HBDH,AST （r=0.275,0.415,0.512,0.198,P〈 0.05）.Conclusion The serum lactic acid level in children with hand-foot-mouth disease rises,and the indexes of nerve injury and myocardial damage also increase,which display a positive correlation,therefore,the serum lactic acid content can be used as a predictive index of nerve iniury and myocardial damage in hand-foot-mouth disease.