组合检测指标在手足口病早期诊断中的价值  

Clinical evaluation of combined detection indexes in early diagnosis of hand-foot-mouth disease

作　　者：黄伟[1] 李芹[2] 官升灿[2] 刘路[2] 周文[2] 

机构地区：[1]福建中医药大学研究生院,福建福州350100 [2]福州市传染病医院感染科,福建福州350000

出　　处：《临床荟萃》2015年第7期785-788,共4页Clinical Focus

基　　金：国家"十二五"重大科技专项资助项目(2012ZX10004301-005);福州市卫生系统科技计划项目(2013-Swt8);福州市科技计划项目(2014-S-139-9)

摘　　要：目的探讨组合检测指标在早期诊断手足口病(HFMD)中的临床价值及其有效性。方法选取手足口病患者100例,其中重症组、轻症组各50例,另设对照组30例,检测白细胞(WBC)、中性粒细胞计数及百分比(NEUT#、NEUT%)、高敏C反应蛋白(hs-CRP)、降钙素原(PCT)、白细胞介素6(IL-6)、血糖(GLU)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、病毒核酸类型等指标,观察上述指标在重症组、轻症组、对照组的变化。结果重症组、轻症组IL-6、PCT、WBC、NEUT#、ALT、AST均显著高于对照组(P<0.05),但重症组与轻症组之间比较,差异无统计学意义(P>0.05);轻症组hs-CRP显著高于重症组和对照组(P<0.01),而重症组与对照组之间差异无统计学意义(P>0.05);重症组、轻症组、对照组之间NEUT%、GLU均差异无统计学意义(P>0.05);肠道病毒71型(EV71)在重症组中占58.0%,轻症组占4.0%,其他通用型肠道病毒(包括CoxA16)在重、轻症组分别占42.0%、96.0%,并且差异有统计学意义(P<0.01)。结论 HFMD重症组、轻症组在上述组合检测指标中大多与对照组有明显差异,但与病情无明显关系;病情重反而hs-CRP水平较低;EV71仍是重症HFMD的主要病毒类型。Objective To evaluate the clinical value and effectivity of combined detection indexes in the early diagnosis of hand-foot-mouth disease.Methods One hundred patients with hand-foot-mouth disease were divided into severe group and mild group,and thirty cases were selected as control group.White blood cell（WBC）,neutrophil count and percentage（NEUT#,NEUT%）,high sensitive C reactive protein（hs-CRP）,procalcitonin（PCT）,interleukin-6（IL-6）,blood glucose（GLU）,alanine aminotransferase（ALT）,aspartate aminotransferase（AST）and the type of the viral nucleic acid were observed in severe group,mild group and control group.Results IL-6,PCT,WBC,NEUT#,ALT and AST were significantly higher in severe and mild groups than in control group（P〈0.01）,while the indexes showed no significant difference between severe group and mild group（P〈0.05）;hs-CRP was significantly higher in mild group than in severe and control groups（P〈0.01）,while hs-CRP showed no significant difference between severe group and control group（P 〉0.05）;There were no significant difference in NEUT% and GLU among three groups（P〉 0.05）;EV71accounted for 58.0% in severe group and 4.0% in mild group,other universal enterovirus（including CoxA16）in severe and mild groups accounted for 42.0%,96.0%,respectively,and the difference had statistical significance（P〈0.01）.Conclusion Most of combined detection indexes above showed significant difference in severe and mild groups than in control group,while no direct relationship with the patients＇ condition was found;In serious condition,hs-CRP was lower;EV71is a major virus type of severe hand-foot-mouth disease.

关 键 词：手足口病 降钙素原 C反应蛋白质 白细胞介素6 早期诊断 

分 类 号：R512.5[医药卫生—内科学]