手足口病重型患儿血清炎症指标检测的临床意义  

Clinical significance of the changes of serum inflammatory indicators in children with severe hand,foot and mouth disease

作　　者：王晓冬[1] 霍习敏[1] 张银瑞[1] 耿文锦[1] 康磊[1] 周晓强[1] 

机构地区：[1]河北省儿童医院重症监护科,河北石家庄050031

出　　处：《中华医院感染学杂志》2015年第24期5694-5696,共3页Chinese Journal of Nosocomiology

基　　金：河北省科技厅支撑基金资助项目(122777128)

摘　　要：目的通过监测手足口病(HFMD)重型患儿血清降钙素原(PCT)、C-反应蛋白(CRP)、白介素-6(IL-6)、白介素-10(IL-10)、肿瘤坏死因子(TNF-α)水平,以判断炎症反应程度,达到最佳治疗。方法采用前瞻性分析2013年2-11月重症医学科收治的手足口病重型患者98例,根据其严重程度分为:重症组52例及危重症组46例;同期选取50名健康儿童为对照组,患儿入院后立即采集静脉血,进行PCT、CRP、IL-6、IL-10、TNF-α等指标检测,数据采用SPSS 17.0软件进行统计分析。结果危重型组中的CRP、IL-6和TNF-α与重型组均显著高于对照组,两组比较差异有统计学意义(P<0.05);危重型组患儿PCT、IL-10与对照组比较,均显著升高(P<0.05),但与危重组比较,差异无统计学意义。结论在手足口病重症患儿病情进展中,血清CRP比PCT更具有敏感性的炎症指标,IL-6、IL-10、TNF-α细胞因子参与了HFMD重症急性期炎症和抗炎反应;EV71阳性病例具有更加明显的免疫反应。OBJECTIVE To monitor the changes of procalcitonin, c-reactive protein, interleukin 6, interleukin 10 and tumor necrosis in children with severe hand, foot and mouth disease （HFMD）, so as to make a judgment of degree of inflammatory reaction and to provide best therapies. METHODS The clinical data of 98 cases of children with severe HFMD admitted in ICU from Feb. to Nov. 2013 were analyzed retrospectively. The patients were divided into two groups： the severe group with 52 cases and the critically severe group with 46 cases according to the severity. In the same period, 50 healthy children were chosen as the control group. The blood was drawn immediately after admission to hospital to detect the indicators such as PCT, CRP, IL-6, IL-10, TNF-αand so on. SPSS 17.0 was adopted for statistical analysis. RESULTS Compared with control group, the levels of C-reactive protein, the IL-6, and TNF-α in the critical severe group and severe group were significantly higher （P 〈0.05）. The levels of PCT and the IL-10 in the critical severe group were significantly higher than the control group （P〈0.05）, but there was no significant difference between the severe group and the critical severe group. CONCLUSION Com- pared with PCT, serum CRP was proved to be a more sensitive inflammatory indicator during the development of HFMD. A variety of cytokines（the IL-6, the IL-10 and the TNF-α）which produce severe inflammation and antiinflammatory responses involved in the pathogenesis and the development of severe HFMD cases. EV71 positive cases have more obvious immune response.

关 键 词：手足口病 重症患儿 C-反应蛋白、血清炎性因子 

分 类 号：R446[医药卫生—诊断学]