手足口病并发脑炎患儿水通道蛋白4水平变化及其与炎症因子、神经损伤指标相关性

Study on the correlations between the level of aquaporin 4 and inflammatory factors,nerve injury indexes in children with HFMD complicated with encephalitis

目的:探讨手足口病并发脑炎患儿水通道蛋白4水平变化及其与炎症因子、神经损伤指标相关性。方法:选取40例手足口病神经系统受累期患儿作为观察组,选取同期收治的40例手足口病出疹期患儿作为单纯手足口病组,36例排除手足口病及脑炎等其他疾病的热性惊厥患儿作为对照组。检测脑脊液中水通道蛋白4水平及外周血中炎症因子[白细胞介素-1β(IL-1β)、IL-6、IL-18、C反应蛋白(CRP)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)]、神经损伤指标[髓鞘碱性蛋白(MBP)、神经特异性烯醇化酶(NSE)、S-100B蛋白]水平,分析脑脊液中水通道蛋白4水平与外周血中炎症因子及神经损伤指标相关性。结果:入院第2天患儿脑脊液水平观察组高于单纯手足口病组和对照组(P<0.01);入院第7天(恢复期),观察组脑脊液水通道蛋白4水平较入院第2天降低,仍高于单纯手足口病组(P<0.01)。3组患儿外周血炎症因子、神经损伤指标水平差异有统计学意义(P<0.01)。相关性分析显示,观察组第2天脑脊液水通道蛋白4与外周血中炎症因子及神经损伤指标均呈正相关关系(P<0.05~P<0.01)。结论:手足口病并发脑炎患儿脑脊液中水通道蛋白4水平在急性期升高,在恢复期降低,且与外周血炎症因子、神经损伤指标呈正相关。

Objective:To study the the correlations between the level of aquaporin 4 and inflammatory factors,nerve injury indexes in children with hand,foot and mouth disease(HFMD)complicated with encephalitis.Methods:Forty children with HFMD complicated with nerve system involvement were set as the observation group,40 children with rashes of HFMD were set as the simple HFMD group,and 36 febrile convulsion children without HFMD and encephalitis were set as the control group.The level of aquaporin 4 in cerebrospinal fluid,serum levels of inflammatory factors[including the interleukin(IL)-1β,IL-6,IL-18,C reactive protein(CRP),procalcitonin(PCT)and tumor necrosis factor(TNF)-α]and nerve injury index levels[including the myelin basic protein(MBP),nerve specific enolase(NSE)and S-100B proteins]in peripheral blood were detected.The correlations between the level of aquaporin 4 and inflammatory factors,nerve injury indexes in peripheral blood were analyzed.Results:The level of aquaporin 4 of cerebrospinal fluid in observation group on the second day of admission was higher than that in simple HFMD group and control group(P<0.01).The level of aquaporin 4 in observation group on the seventh day of admission was higher than that on the second day of admission,and in simple HFMD group and control group(P<0.01).The differences of the levels of inflammatory factors and nerve injury indexes among three groups were statistically significant(P<0.01).The results of correlation analysis showed that the level of aquaporin 4 of cerebrospinal fluid in the observation group on the second day of admission was positively correlated with the peripheral inflammatory factors and nerve injury indexes(P<0.05 to P<0.01).Conclusions:The level of aquaporin 4 in children with HFMD complicated with encephalitis increases in the acute phase,decreases in the recovery phase,and is positively correlated with the inflammatory factors and nerve injury indexes.