重症手足口病生化指标变化特点探讨  

Discussion on variation characteristics of biochemical indicators of severe hand,foot and mouth disease

作　　者：高艳霞[1] 张志英[1] 李琦[1] 尚卫红[1] 刘静兰[1] 马宁[2] 

机构地区：[1]邯郸市妇幼保健院检验科,河北邯郸056001 [2]河北医科大学社会医学与卫生事业管理教研室,河北石家庄050017

出　　处：《临床荟萃》2013年第5期505-508,共4页Clinical Focus

摘　　要：目的旨在分析重症手足口病的生化指标的变化特征,探讨超敏肌钙蛋白I(TropI)、肾上腺素、去甲肾上腺素等生化指标在早期提示病情恶化方面的作用和价值。方法采用回顾性分析方法,对1 255例手足口病患儿的白细胞(WBC)、血糖(GLU)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)和肌钙蛋白I(TropI)等指标进行分析;另对125例手足口病患儿血清肾上腺素水平和323例手足口病患儿血清去甲肾上腺素水平进行分析。结果重症患儿组WBC(15.4±6.1)×109/L、GLU(10.5±3.9)mmol/L、CK(102.9±51.0)U/L、CK-MB(30.6±10.6)U/L、TropI(0.39±0.143)μg/L与普通患儿组WBC(9.2±4.2)×109/L、GLU(4.0±1.8)mmol/L、CK(70.5±24.0)U/L、CK-MB(12.6±5.6)U/L、TropI(0.02±0.02)μg/L的水平比较明显升高(均P<0.01),且随病情加重进一步升高;重型和危重型患儿去甲肾上腺素水平分别为(539.455±236.206)ng/L和(734.344±245.461)ng/L,与普通组(363.874±223.671)ng/L比较差异均有统计学意义,而重症和死亡组患儿肾上腺素水平分别为(85.82±33.33)μg/L和(94.68±30.17)μg/L,与普通组(69.71±31.09)μg/L相比差异有统计学意义。结论 WBC、GLU、CK、CK-MB、TropI和去甲肾上腺素均是重症手足口病的早期识别指标,尤其TropI>0.30μg/L、去甲肾上腺素明显升高,提示已进入危重期,医护人员应给予高度关注。Objective To study the value of high sensitivity troponin I（TropI）, epinephrine（E）, norepinephrine （NE） et al in early severe hand, foot and mouth disease（HFMD） by analyzing the variation characteristics of these biochemical indicators. Methods White Mood cell （WBC）, glucose （ GLU）, ereatine kinase （ CK）, creatine kinase MB isoenzyme（CK-MB）, TropI and other indexes of 1 255 children with severe HFMD were collected and analyzed. Meanwhile,serum epinephrine of 125 children and serum norepinephrine （NE） of 323 children were determined, respectively. Results The levels of WBC,GLU,CK,CK-MB,TropI in intensive HFMD group were significantly higher than those in common cases group,WBC（15.4±6.1） ×10^9/L vs （9.2±4.2）×10^9/L,GLU（10.5±3.9） mmol/L vs （4.0±1. 8） mmol/L,CK（102. 9±51. 0） U/L vs （70.5±24.0） U/L,CK-MB（30.6±10.6）U/L vs （12.6±5.6） U/ L,TropI（0.39±0.14） μg/L vs （0.02 ± 0.02） μg/L（all P d0.01）, respectively. Meanwhile, the level of NE in the heavy type （539. 455±236. 206） ng/L and critical type （734. 344±245. 461） ng/L were significantly higher than that of common cases group （363. 874±223. 671） ng/L. The levels of E in the severe group （85.82± 33.33） μg/L and death group （94.68± 30.17） μg/L were significantly higher than those in common cases group（69.71± 31.09）μg/L. Conclusion WBC,GLU,CK,CK-MB,TropI and NE are biochemical markers of HFMD. Especially,TropI 〉0.30μg/L and significant increase of NE appear to be early predictors of severe HFMD.

关 键 词：手足口病 去甲肾上腺素 干预性研究 

分 类 号：R512.57[医药卫生—内科学]