趋化因子MIG、MCP-1、IP-10在重症手足口病中的预警价值分析

Values of chemokines MIG,MCP-1 and IP-10 for the early warning of severe hand-foot-mouth disease

目的探讨诱导单核因子(MIG)、单核细胞趋化蛋白-1(MCP-1)、诱导蛋白-10(IP-10)的浓度变化在手足口病疾病分期和预后判断中的临床意义,以及对重症手足口病的预警价值分析。方法选择2017年1月-2019年12月153例手足口病患者,按照病情轻重程度分为轻症组64例,重症组58例,危重症组21例,另选30例健康体检儿童为对照组。采用流式微球阵列分析术(CBA)检测血清中IP-10、MCP-1、MIG的浓度。结果重症组、危重症组中MIG、MCP-1、IP-10浓度明显高于对照组(P<0.05);且重症组、危重症组MIG、MCP-1、IP-10浓度也明显高于轻症组(P<0.05);重症组与危重症组之间差异无统计学意义(P>0.05)。MCP-1轻症组高于对照组(P<0.05)。MIG、IP-10轻症组与对照组之间差异无统计学意义(P>0.05)。采用ROC曲线分析,选取MCP=451.60 pg/ml为诊断临界点,灵敏度为94.2%、特异度为65.2%,提示MCP-1对重症手足口病诊断具有较好的预测价值。结论趋化因子IP-10、MCP-1、MIG在手足口病的重症化进展中起着重要作用,其水平的变化对疾病的预后判断和治疗有一定的参考价值,MCP-1对疾病重症化的预警价值更优。

Objective To explore the clinical significances of concentration changes of chemokines monokine induced by IFN-γ(MIG),monocyte chemoattractant protein-1(MCP-1)and IFN-γinducible protein-10(IP-10)in the staging and prognosis evaluation of hand-foot-mouth disease and to analyze their values for the early warning of severe hand-foot-mouth disease.Methods A total of 153 patients diagnosed from January 2017 to December 2019 were selected and divided into three groups according to severity of the disease:mild group(n=64),severe group(n=58),critical group(n=21).Additionally,30 healthy children were enrolled as controls.The concentrations of serum IP-10,MCP-1 and MIG were detected by cytometric bead array(CBA).Results The concentrations of IP-10,MCP-1 and MIG in the severe group were significantly higher than the normal group(P<0.05);those of IP-10,MCP-1 and MIG in the severe group and critical group were much higher than the mild group(P<0.05);the differences between the severe group and the critical group had statistical significance(P<0.05).The concentration of MCP-1 in the mild group was higher than the normal group(P<0.05).There was no statistical significance on the differences between the mild group and control group in the concentrations of MIG and IP-10(P>0.05).ROC analysis showed that,sensitivity was 94.2%and specificity was 65.2%when MCP=451.60 pg/ml was set as the diagnostic threshold,suggesting that MCP-1 had statistical significance as a predictor for the diagnosis of severe hand-foot-mouth disease.Conclusion Chemokines MIG,MCP-1 and IP-10 play important roles in the progression of hand-foot-mouth disease in the final stage.Changes in MIG,MCP-1 and IP-10 concentrations can provide reference for the prognosis evaluation and treatment of such disease.MCP-1 is more helpful in the early warning of severe hand-foot-mouth disease in the final stage.