内皮素-1对儿童重症手足口病合并神经源性肺水肿的临床意义

Clinical significance of endothelin-1 level in children with severe hand-foot-mouth disease complicated with neurogenic pulmonary edema

目的探讨内皮素-1(ET-1)对重症手足口病(HFMD)合并神经源性肺水肿(NPE)的临床意义。方法选取2019年1月至2020年11月在河南省儿童医院住院治疗的HFMD患儿126例为病例组(男70例、女56例),根据病情轻重程度分为普通组(57例)、重症无NPF组(41例)、重症合并NPF组(28例)。同期选取30例健康体检儿童作为对照组(男13例、女17例)。观察并对比儿童血清及脑脊液ET-1水平。结果血清和脑脊液ET-1水平在重症合并NPE组明显升高,差异均有统计学意义(均P<0.05)。作为预测重症HFMD合并NPE的指标时,血清ET-1的曲线下面积为0.804(95%CI:0.693~0.915),脑脊液ET-1的曲线下面积为0.916(95%CI:0.842~0.991)。结论ET-1或可能成为预测重症HFMD合并NPE的一项重要生物标志物。

Objective To explore the clinical significance of endothelin-1(ET-1)level in children with severe hand-foot-mouth disease(HFMD)complicated with neurogenic pulmonary edema(NPE).Methods A retrospective study was performed on 126 children with HFMD(70 males and 56 females)admitted to Henan Children's Hospital from January 2019 to November 2020.According to the severity of the condition,126 children were divided into a normal group(57 cases),a severe HFMD group without NPE(41 cases),a severe HFMD group with NPE(28 cases).Meanwhile,30 age-matched healthy children(13 males and 17 females)were selected as controls.Serum and cerebrospinal fluid(CSF)ET-1 levels were observed.Results Serum and CSF ET-1 levels of the severe HFMD group with NPE significantly increased compared with those of the other three groups(all P<0.05).As an indicator for predicting severe HFMD with NPE,the area under the curve of serum ET-1 was 0.804(95%CI:0.693-0.915),and the area under the curve of CSF ET-1 was 0.916(95%CI:0.842-0.991).Conclusion ET-1 may be used as one of the predictors of severe HFMD complicated with NPE.