外周血BNP及TLR3、NF-κB水平与手足口病患儿病情、预后的相关性

The Correlation between Peripheral Blood BNP and TLR3,NF-κB Levels and the Condition and Prognosis of Children with Hand,Foot,and Mouth Disease

目的探究外周血B型钠尿肽(BNP)及Toll样受体3(TLR3)、核因子κB(NF-κB)水平与手足口病患儿病情、预后的相关性。方法选取2021年8月至2023年8月邓州市疾病预防控制中心收治的102例手足口病患儿为研究对象,根据患儿患病轻重程度将其分为重症组43例,轻症组59例,对比两组患儿外周血BNP及TLR3、NF-κB水平。对出院患儿进行3个月随访,根据随访结果将预后良好患儿纳入良好组,预后不良患儿纳入不良组。多因素分析采用Logistic回归方程,受试者工作特征曲线(ROC)分析BNP、TLR3、NF-κB表达水平对手足口病患儿预后的预测价值。结果重症组患儿BNP、TLR3、NF-κB表达水平均高于轻症组,差异有统计学意义(P<0.05);不良组和良好组患儿性别、体质量指数(BMI)值、合并发热及合并皮疹相比较差异无统计学意义(P>0.05);不良组患儿年龄<3岁占比、合并肺部渗出性病变占比、合并循环障碍占比、BNP、TLR3及NF-κB水平均高于良好组,差异有统计学意义(P<0.05);经Logistic回归分析,BNP、TLR3、NF-κB表达均为影响手足口病患儿预后的独立危险因素(P<0.05);经ROC曲线分析,BNP、TLR3、NF-κB水平表达均对手足口病患儿预后不良发生均有较高的预测价值,曲线下面积(AUC)分别为0.908、0.950、0.904。结论重症手足口病患儿BNP、TLR3、NF-κB表达水平均高于轻症患儿,对评估病情严重程度具有较高参考价值,且高水平BNP、TLR3、NF-κB均为手足口病患儿预后不良的独立危险因素。

Objective To explore the correlation between the levels of B-type natriuretic peptide(BNP),Toll-like receptor 3(TLR3),and nuclear factorκB(NF-κB)in peripheral blood and the condition and prognosis of children with hand,foot,and mouth disease.Methods 102 cases of children with hand,foot,and mouth disease treated in Dengzhou Center for Disease Control and Prevention from August 2021 to August 2023 were selected as the research subjects.According to the severity of the disease,they were divided into a severe group(43 cases)and a mild group(59 cases).The levels of BNP,TLR3,and NF-κB in peripheral blood of the two groups were compared.The discharged patients were followed up for 3 months.According to the follow-up results,the patients with good prognosis were included in the good group,and those with poor prognosis were included in the poor group.Multivariate analysis was performed using the Logistic regression equation,and the predictive value of BNP,TLR3,and NF-κB expression levels for the prognosis of children with hand,foot,and mouth disease was analyzed by the receiver operating characteristic(ROC)curve.Results The expression levels of BNP,TLR3,and NF-κB in the severe group were all higher than those in the mild group,with statistically significant differences(P<0.05).There was no statistically significant difference in the comparison of gender,body mass index(BMI)value,combined fever,and combined rash between the poor group and the good group(P>0.05).The proportion of patients aged<3 years,the proportion of combined pulmonary exudative lesions,the proportion of combined circulatory disorders,and the levels of BNP,TLR3,and NF-κB in the poor group were all higher than those in the good group,with statistically significant differences(P<0.05).Logistic regression analysis showed that the expressions of BNP,TLR3,and NF-κB were all independent risk factors affecting the prognosis of children with hand,foot,and mouth disease(P<0.05).ROC curve analysis showed that the expression levels of BNP,TLR3,and NF-κB all had a high predictive value for the occurrence of poor prognosis in children with hand,foot,and mouth disease,and the area under the curve(AUC)was 0.908,0.950,and 0.904,respectively.Conclusion The expression levels of BNP,TLR3,and NF-κB in children with severe hand,foot,and mouth disease are all higher than those in children with mild disease,and they have a high reference value for assessing the severity of the disease.Moreover,high levels of BNP,TLR3,and NF-κB are all independent risk factors for poor prognosis in children with hand,foot,and mouth disease.