皮质醇在评价重症和危重症手足口病患儿病情及预后中的价值

The Value of Cortisol in the Evaluation of the Condition and Prognosis of Severe and Critical Hand, Foot and Mouth Disease

目的探讨对重症以及危重症手足口病患儿在进行病情以及预后评估期间皮质醇应用可行性。方法选择该院2017年6月-2019年1月收治的120例重症以及危重症手足口病患儿作为实验对象;依据病情表现,分为A1组(15例重症组)以及A2组(危重症组105例);在患者出院时,依据患者后遗症出现情况,分为B1组(无后遗症组105例)以及B2组(后遗症组15组)。对所有手足口病患儿于临床展开血清血糖水平检测,利用葡萄糖氧化酶法完成;展开ACTH(促肾上皮质激素)水平以及COR(血清皮质醇)水平检测,利用化学发光检测法完成;最终就系列结果展开对比。结果A1组平均年龄为(23.90±12.19)月,机械通气时间为(0.00±0.00)d,住院时间为(4.19±0.72)d;A2组平均年龄为(19.79±4.69)月,机械通气时间为(2.75±2.15)d,住院时间为(9.76±4.02)d;A1组手足口病患儿年龄大于A2组明显,差异有统计学意义(t=2.447,P<0.05);A1组手足口病患儿机械通气时间以及住院时间均短于A2组明显,差异有统计学意义(t=4.936,5.335,P<0.05);A1组手足口病患儿血糖水平同A2组比较差异无统计学意义(t=1.225,P>0.05);A1组手足口病患儿ACTH水平以及COR水平小于A2组明显,差异有统计学意义(t=5.892,10.157,P<0.05);B1组手足口病患儿ACTH水平以及COR水平小于B2组明显,差异有统计学意义(t=2.727,4.131,P<0.05)。结论同重症手足口病患儿比较,危重症患儿的ACTH水平以及COR水平呈现出显著增加,使得机械通气时间以及住院时间有所延长,从而证明对重症以及危重症手足口病患儿实施ACTH水平以及COR水平检测的价值显著。

Objective To investigate the feasibility of cortisol application in patients with severe and critically handfoot-mouth disease during the course of disease and prognosis.Methods 120 children with severe and hand-footmouth disease who were admitted to our hospital from June 2017 to January 2019 were selected as subjects.According to the condition,they were divided into A1 group(15 severe cases)and A2 group(105 patients in the severe group;in the discharge of patients,according to the occurrence of sequelae of patients,divided into B1 group(105 cases without sequelae group)and B2 group(sequence group 15 cases).Serum blood glucose levels were measured in all children with hand,foot and mouth disease by glucose oxidase method;ACTH(pro-renal corticosteroid)levels and COR(serum cortisol)levels were detected and detected by chemiluminescence detection;Compare the results of the series.Results The mean age of group A1 was(23.90±12.19)months,the duration of mechanical ventilation was(0.00±0.00)d,the length of hospital stay was(4.19±0.72)d;the mean age of group A2 was(19.79±4.69)months,mechanical ventilation time(2.75±2.15)d,hospitalization time was(9.76±4.02)d;age of children with hand,foot and mouth disease in group A1 was significantly higher than that in group A2,the difference was statistically significant(t=2.447,P<0.05);mechanical ventilation time of children with hand,foot and mouth disease in group A1 of hospitalization time was shorter than that in the A2 group(t=4.936,5.355,P<0.05).The blood glucose level of the children with hand,foot and mouth disease in the A1 group was not significantly different from that in the A2 group(t=1.225,P>0.05);The levels of ACTH and COR in children with oral disease were significantly lower than those in A2 group(t=5.892,10.157,P<0.05).The levels of ACTH and COR in children with B-group were significantly lower than those in group B2,the difference was statistically significant(t=2.727,4.131,P<0.05).Conclusion Compared with children with severe hand,foot and mouth disease,there was a significant increase in ACTH levels and COR levels in critically ill children,resulting in prolonged mechanical ventilation and hospital stay,demonstrating the implementation of severe and critically handfoot-mouth disease in children.The value of ACTH level and COR level detection is significant.