儿童EV71型手足口病血清内皮素-1和炎性因子水平及其与重型发病的关系

Serum endothelin-1 and inflammatory factors in children with EV71-induced hand, foot and mouth disease and their association with severe condition

目的 探讨儿童肠道病毒71型(EV71)手足口病(HFMD)血清内皮素-1(ET-1)和炎性因子水平及其与重型发病的关系。方法 选取2015年1月-2020年12月在青岛市中医医院就诊的100例EV71感染手足口病患儿为病例组,根据病情严重程度分为轻型组55例和重型组45例;并选取同期82名健康体检儿童为对照组,所有入组者均采用酶联免疫吸附法检测ET-1、C-反应蛋白(CRP)、白细胞介素-8(IL-8)、γ-干扰素(IFN-γ)水平,分析血清ET-1、炎性反应与重型发病的关系。结果 病例组患儿血清ET-1、CRP、IL-8、IFN-γ水平均高于对照组(P<0.05);重型组患儿血清ET-1、CRP、IL-8、IFN-γ水平均高于轻型组(P<0.05);多因素Logistic回归分析显示年龄、发病-就诊时间间隔、ET-1是EV71型手足口病患儿重型发病的危险因素。结论 EV71感染手足口病患儿血清ET-1水平和炎性因子CRP、IL-8、IFN-γ水平明显升高,且ET-1与年龄、发病-就诊时间间隔均是EV71型手足口病重型发病的危险因素。

OBJECTIVE To explore the serum endothelin-1(ET-1) and inflammatory factors in children with enterovirus 71(EV71)-induced hand, foot and mouth disease(HFMD) and analyze their association with severe condition. METHODS A total of 100 children with EV71 infection-induced HFMD who were treated in Qingdao Hospital of Traditional Chinese Medicine from Jan 2015 to Dec 2020 were chosen as the case group, the children of the case group were divided into the mild group with 55 cases and the severe group with 45 cases according to the severity of illness condition. Meanwhile, 82 healthy children who received physical examination were chosen as the control group. The levels of ET-1, C-reactive protein(CRP), interleukin-8(IL-8) and interferon-γ(IFN-γ) of all the patients were detected by enzyme-linked immunosorbent assay(ELISA). The association of serum ET-1, inflammatory response with the severe condition was observed. RESULTS The levels of serum ET-1, CRP, IL-8 and IFN-γ of the case group were higher than those of the control group(P<0.05). The levels of serum ET-1, CRP, IL-8 and IFN-γ of the severe group were higher than those of the mild group(P<0.05). Multivariate logistic regression analysis showed that age, time interval between onset and treatment, and ET-1 were the risk factors for the severe condition of the children with EV71 infection-induced HFMD. CONCLUSION The children with EV71 infection-induced HFMD show remarkable rise of serum ET-1 and inflammatory factors CRP, IL-8 and IFN-γ. ET-1, age and time interval between onset and treatment are the risk factors for the onset of severe condition.