血清淀粉样蛋白A联合空腹血糖检测在手足口病首诊患儿病情及疾病预后评估中的价值

Value of serum amyloid A combined with fasting blood glucose in evaluation of condition and prognosis of firstly-diagnosed children with hand-foot-mouth disease

目的:探讨血清淀粉样蛋白A(SAA)联合空腹血糖(FBG)检测在手足口病首诊患儿病情及疾病预后评估中的价值。方法:选取HFMD患儿362例为试验组,按照疾病严重程度进行分级。选取同期健康体检儿童121例为对照组。比较两组血清SAA、FBG水平,采用受试者工作特征(ROC)曲线分析两者对HFMD的诊断效能。比较试验组治疗前后SAA、FBG水平。对HFMD患儿进行随访,根据是否出现后遗症分为预后良好组和预后不佳组并进行SAA、FBG水平比较,分析两者与患儿预后的相关性。结果:试验组血清SAA、FBG水平显著高于对照组,且随着疾病的发展,试验组以上指标呈现升高趋势(均P<0.05)。ROC曲线分析显示,SAA、FBG均对HFMD具有较高的诊断效能,两者联合的诊断效能更高,曲线下面积(AUC)为0.910,敏感性为72.69%,特异性为83.41%。治疗后HFMD患儿血清SAA、FBG明显低于治疗前(均P<0.05)。预后良好组HFMD患儿血清SAA、FBG水平明显低于预后不佳组(均P<0.05)。血清SAA、FBG水平与HFMD患儿预后呈正相关(r=0.993、0.906,均P<0.05)。结论:血清SAA联合FBG检测可为HFMD早期诊断提供有效依据,在疾病严重程度判断及预后评估中均具有一定应用价值。

Objective:To investigate the value of serum amyloid A(SAA)combined with fasting blood glucose(FBG)in the evaluation of condition and prognosis of firstly-diagnosed children with hand-foot-mouth disease(HFMD).Methods:Totally 362 children with HFMD were selected as the experimental group and graded according to the severity of the disease.121 healthy children in the same period were selected as the control group.The levels of serum SAA and FBG were compared between the two groups,and the diagnostic efficacy of the two indicators for HFMD was analyzed by receiver operating characteristic(ROC)curve.The levels of SAA and FBG in the experimental group were compared before and after treatment.The children with HFMD were followed up and divided into good prognosis group and poor prognosis group according to whether there were sequelae,and the levels of SAA and FBG were compared to analyze the correlation between them and the prognosis of children with HFMD.Results:The levels of serum SAA and FBG in the experimental group were significantly higher than those in the control group,and the above indexes in the experimental group showed an upward trend with the development of the disease(all P<0.05).ROC curve analysis showed that both SAA and FBG had higher diagnostic efficacy for HFMD,and the combined diagnostic efficacy was higher,the area under the curve(AUC)was 0.910,the sensitivity was 72.69%,and the specificity was 83.41%.After treatment,serum SAA and FBG in children with HFMD were significantly lower than those before treatment(all P<0.05).The levels of serum SAA and FBG in good prognosis group were significantly lower than those in poor prognosis group(all P<0.05).The levels of serum SAA and FBG were positively correlated with the prognosis of children with HFMD(r=0.993,0.906,all P<0.05).Conclusion:The detection of serum SAA combined with FBG can provide an effective basis for the early diagnosis of HFMD,and has a certain application value in the judgment of disease severity and prognosis.