不同类型手足口病患儿肠黏膜屏障功能测定的临床意义  

Clinical Significance of Intestinal Mucosal Barrier Function Determination in Children with Hand-Foot-Mouth Disease

作　　者：杨娟[1] 黄永坤[1] 王美芬[2] 杜曾庆[2] 和灿琳[2] 刘梅[1] 高晓琳[1] 周丽芳[1] 

机构地区：[1]昆明医学院第一附属医院儿科,昆明650032 [2]昆明市儿童医院内一科,昆明650011

出　　处：《实用儿科临床杂志》2010年第10期731-732,共2页Journal of Applied Clinical Pediatrics

基　　金：云南省中青年学术技术带头人后备人才培养计划项目(2006PY1-18)

摘　　要：目的探讨手足口病(HFMD)患儿血浆内毒素、二胺氧化酶(DAO)和D-乳酸的变化及其临床意义。方法选取昆明市儿童医院2009年5-7月40例HFMD患儿(研究组)和同期体检的30例健康儿童(对照组)。研究组根据病情轻重再分为重症组(n=14)和非重症组(n=26)。二组儿童均采集空腹静脉血2～3 mL,分离血浆,测定血浆中内毒素、DAO和D-乳酸水平,并比较各组内毒素、DAO和D-乳酸水平。采用SPSS11.5软件进行统计学分析。结果研究组患儿血浆内毒素和D-乳酸水平明显高于对照组(t=4.577、3.419,Pa<0.01)。研究组患儿血浆DAO水平与对照组比较差异无统计学意义(t=0.978,P>0.05)。重症组、非重症组、对照组3组间内毒素、DAO、D-乳酸水平比较差异均有统计学意义(F=40.638、6.399、10.796,Pa<0.01),组间两两重症组均显著高于非重症组和对照组(Pa<0.01),非重症组与对照组比较差异均无统计学意义(Pa>0.05)。结论血浆内毒素、DAO和D-乳酸是肠黏膜损伤早期诊断的敏感指标;重症HFMD患儿存在肠黏膜屏障功能的损伤。Objective To explore the changes and clinical significance of plasma endotoxin,diamine oxidase（DAO） and D-lactate in children with hand-foot-mouth disease（HFMD）.Methods Forty children with HFMD were selected as study group in Kunming Children′s Hospital from May to Jul.2009,and 30 healthy children were selected as control group.The children in study group were divided into critical ill group（n=14） and no-critical ill group（n=26）.All children were required to the blood 2-3 mL from vein.The plasma endotoxin,DAO and D-lactate were detected by spectrophotography,and the differences in all groups were analyzed.Results The levels of endotoxin and D-lactate in study group were significantly higher than those in control group（t=4.577,3.419,Pa0.01）,there was no statistic significance of DAO between study group and control group（t=0.978,P0.05）.There were significant differences of the levels of endotoxin,DAO and D-lactate between critical ill group,no-critical ill group and control group（F=40.638,6.399,10.796,Pa0.01）.Conclusions The plasma endotoxin,DAO and D-lactate can be used as a sensitive marker to early diagnose gastrointestinal mucosal barrier dysfunction.The damage of intestinal mucosal barrier function was existed in children with critical HFMD.

关 键 词：手足口病 内毒素 二胺氧化酶 D-乳酸 儿童 

分 类 号：R725.1[医药卫生—儿科]