手足口病患儿心肌酶等血清指标的分析

Analysis of various serum indexes in children with hand-foot-and-mouth disease

目的分析手足口病患儿心肌酶等血清指标的临床意义。方法选取2016年1月至2016年3月在昆明市妇幼保健院治疗的手足口病患儿179例,其中21例为危重型患儿,89例为重型患儿,69例为普通型患儿,同时选取健康儿童30例作为对照组,检测各组血清心肌酶、心肌肌钙蛋白I、神经元特异性烯醇化酶(NSE)和S-100#蛋白(S-100#)水平。结果危重型手足口病患儿血清乳酸脱氢酶(LDH)、α-羟丁酸酶(α-HBDH)、肌酸激酶(CK)和肌酸激酶同工酶(CK-MB)分别为(402.13±34.29)IU/L、(312.37±61.92)IU/L、(154.20±17.82)IU/L和(27.83±9.04)IU/L,均高于重型和普通型患儿,差异均具有统计学意义(F值分别为4.581和4.294,5.394和7.933,8.104和9.373,10.014和11.294,均P<0.05),而CTnI为(0.11±0.02)IU/L,均低于重型和普通型患儿,差异均具有统计学意义(F值分别为7.693和9.032,均P<0.05);危重型和重型手足口病患儿NSE为(27.10±6.52)ng/mL和(19.43±6.10)ng/mL,S-100#分别为(730.14±42.19)pg/mL和(420.11±32.27)pg/mL,均高于普通型患儿和对照组,差异均具有统计学意义(F值分别为8.932和10.294,11.043和9.482,13.295和9.841,10.391和9.843,均P<0.05);危重型患儿NSE和S-100#水平高于重型患儿,差异均具有统计学意义(F值分别为9.032和12.194,均P<0.05);普通型和对照组NSE和S-100#差异比较无统计学意义(F值分别为1.432和1.043,均P>0.05)。结论血清心肌酶及心肌肌钙蛋白的检测能尽早发现手足口病患儿心肌损害,并及时治疗;NSE和S-100#蛋白在危重型和重型手足口病患儿中明显增高,与病情的严重程度有关。

Objective To analyze the clinical significance of various serum indexes in children with hand-foot-and-mouth disease（HFMD）.Methods A total of 179 HFMD children treated in Kunming City Maternal and Child Health Hospital during January2016 to March 2016 were selected,including 21 children with critical severe HFMD,89 children with severe HFMD,and 69 children with ordinary HFMD.Meanwhile,30 healthy children were selected as control group.The levels of serum myocardial enzyme and cardiac troponin I（CTnI）,neuron specific enolase（NSE）and S-100# protein were detected.Results The levels of serum lactate dehydrogenase（LDH）,α-hydroxybutyric acid enzyme（α-HBDH）,creatine kinase（CK）and creatine kinase isoenzyme（CK-MB）of the children with critical severe HFMD were 402.13 ±34.29 IU/L,312.37±61.92 IU/L,154.20±17.82 IU/L and 27.83±9.04 IU/L,respectively,which were higher than those of the children with severe HFMD and the children with ordinary HFMD,and the differences were significant（Fvalue was 4.581 and 4.294,5.394 and 7.933,8.104 and 9.373,10.014 and11.294,respectively,all P0.05）.The level of CTnI of the children with critical severe HFMD was 0.11±0.02 IU/L,which was lower than that of the children with severe HFMD and the children with ordinary HFMD,and the differences were of statistical significance（Fvalue was 7.693 and 9.032,respectively,both P0.05）.The levels of NSE of children with critical severe HFMD and children with severe HFMD were 27.10±6.52 ng/mL and 19.43±6.10 ng/mL,while their S-100#levels were 730.14±42.19 pg/mL and 420.11±32.27 pg/mL,respectively,which were higher than those of children with ordinary HFMD and the children in control group,and the differences were of statistical significance（F value was 8.932 and 10.294,11.043 and 9.482,13.295 and9.841,10.391 and 9.843,respectively,all P0.05）.And the levels of NSE and S-100βof children with critical severe HFMD were higher than those of the children with severe HFMD,and the differences were significant（F value was 9.032 and 12.194,respectively,both P0.05）.There were no significant differences in the levels of NSE and S-100 #between the children with ordinary HFMD and the children in control group（F value was 1.432 and 1.043,respectively,both P 0.05）.Conclusion Detection of serum myocardial enzymes and cardiac troponin can detect myocardial damage in children with HFMD as early as possible,which is helpful to provide a timely treatment.In children with critical severe HFMD and children with severe HFMD,the levels of NSE and S-100#protein are significantly increased,which are related to the severity of the disease.