手足口病合并中枢神经系统感染患儿血清中S100B、神经元特异性烯醇化酶水平检测及意义  

Detection of serum S100B and neuron-specific enolase levels in children with hand,foot and mouth disease complicated with central nervous system infection and its significance

作　　者：王晓波[1] 杜潘艳[1] 赵丽梅[1] 乔国昱 王宝林[1] 高翠红[1] 张双[1] 

机构地区：[1]河北省唐山市妇幼保健院检验科,河北唐山063000 [2]河北省唐山市协和医院检验科,河北唐山063000

出　　处：《中国现代医学杂志》2015年第30期95-98,共4页China Journal of Modern Medicine

摘　　要：目的检测手足口病(HFMD)合并中枢神经系统(CNS)感染患儿脑脊液(CSF)和血清S100B、神经元特异性烯醇化酶(NSE)水平,并探讨其临床意义。方法收集临床确诊的HFMD合并CNS感染病例94例,分别根据患儿感染病毒类型、CSF白细胞(WBC)计数(≥15×106/L)、WBC分类、合并CNS感染时间(≤2 d)进行分组。采用ELISA法分别检测S100B、NSE水平。结果病例组血清S100B和NSE水平均高于对照组(P=0.000);与感染肠道病毒类型无关(P>0.05)。患儿血清和CNS中S100B、NSE水平均呈正相关(P=0.000);S100B和NSE水平分别在相同标本类型中呈正相关(P=0.000);不同CSF WBC计数、WBC分类组间血清S100B、NSE水平均无统计学差异(P>0.05);患儿合并CNS感染时间越长,血清S100B、NSE水平越高(P=0.000)。血清S100B、NSE的ROC曲线下面积分别为0.825和0.812,敏感度为77.5%和73.6%,特异性为75.3%和76.5%。结论HFMD合并CNS感染患儿血清S100B、NSE水平能够直接反映出中枢神经系统损伤严重程度,对于判断HFMD病情有重要价值。【Objective】 To detect S100 B and neuron-specific enolase（NSE） levels in serum and CSF of children with hand,foot and mouth disease（HFMD） complicated with central nervous system（CNS） infection and analyze the significance.【Methods】 Totally 94 cases of HFMD children complicated with central nervous system infection were served as case group.And they were grouped according to the type of infected virus,the count of WBC in CSF（≥15×106/L）,the classification of WBC and the period of combined central system infection（≤ 2 days）,respectively.ELISA was performed to detect the levels of the S100 B and NSE.【Results】The serum levels of S100 B and NSE in the case group were higher than those in the control group（P = 0.000）,while there were no differences between the EV71-infected group and the Cox A16-infected group（P〉0.05）.The level of S100 B was in a positive correlation with NSE both in serum（P = 0.000） and CSF（P = 0.000） of the case group;and the level of S100 B in serum was in a positive correlation with that in CSF（P = 0.000）,also the level of NSE in serum was in a positive correlation with that in CSF（P = 0.000）.There were no differences in CSF levels of S100 B and NSE between the groups with different WBC count or classification（P〉0.05）.The serum levels of S100 B and NSE significantly increased in the HFDM children complicated with CNS infection for more than 2 days compared to those with CNS infection for 2 days or less（P = 0.000）.The areas under the ROC curves of the serum S100 B and NSE were 0.825 and 0.812,the sensitivity was 77.5%and 73.6%,and the specificity was 75.3% and 76.5%,respectively.【Conclusions】 Detection of S100 B and NSE levels in serum can directly reflect the injury severity of central nervous system in children of HFMD complicated with central nervous system infection,and has an important value in estimation of HFMD state.

关 键 词：手足口病 中枢神经系统 S100B 神经元特异性烯醇化酶 血清 

分 类 号：R725.1[医药卫生—儿科]