脑脊液EV71抗体检测在重症手足口病合并脑炎中的意义  

The significance of cerebrospinal fluid EV71 antibody detection in severe hand-foot-mouth disease and encephalitis

作　　者：刘娜[1] 王先玉[1] 何谢玲[1] 覃亚斌[1] 

机构地区：[1]湖南省儿童医院检验中心,湖南长沙市410007

出　　处：《实用检验医师杂志》2017年第3期163-166,共4页Chinese Journal of Clinical Pathologist

摘　　要：目的分析脑脊液肠道病毒71(EV71)抗体在早期预测重症手足口病(HFMD)并发脑炎中的价值。方法选取我院2015年3月至2017年3月收治的224例重症HFMD患儿,按照其并发脑炎情况与类型将其纳入未合并脑炎对照组(n=72)、合并细菌性脑炎组(n=86)和合并病毒性脑炎组(n=66),对其血清、脑脊液EV71抗体水平进行检测,运用受试者工作特征曲线(ROC)计算EV71抗体早期预测HFMD并发脑炎的灵敏度、特异度,并运用Logistic多因素回归分析,评价血清EV71抗体对重症HFMD并发脑炎的影响。结果细菌性脑炎组、病毒性脑炎组血清及脑脊液EV71抗体水平均高于未合并脑炎对照组[血清EV71抗体(μg/L):403.5±19.6、397.1±20.8比115.9±32.4,脑脊液EV71抗体(μg/L):427.6±48.4、430.8±49.1比125.9±31.3],差异有统计学意义(均P<0.05),而细菌性脑炎组、病毒性脑炎组血清及脑脊液EV71抗体水平比较差异无统计学意义(均P>0.05)。ROC曲线显示,脑脊液、血清EV71抗体预测重症HFMD并发脑炎的灵敏度(87.83%、85.16%)、特异度(90.52%、89.33%)均较高(均P<0.05)。多因素Logistic回归分析显示,以并发脑炎为因变量,脑脊液与血清EV71抗体的影响因子均具有统计学意义(均P<0.05)。结论重症HFMD并发脑炎可损伤患儿脑组织,并引发脑脊液、血清EV71抗体水平明显上升,血清EV71抗体检测具有简便、创伤小的优势,有望在重症HFMD并发脑炎的早期预测中发挥重要作用。Objective To analyze the value of cerebrospinal fluid enterovirus 71 （EV71） antibody in the early prediction of severe hand-foot-mouth disease （HFMD） complicated with encephalitis. Methods A total of 224 children with severe HFMD who were treated in our hospital from March 2015 to March 2017 were selected for inclusion in the unrelated encephalitis control group （n = 72） and the combined encephalitis group （n = 86） and combined with viral encephalitis （n = 66）. The serum and cerebrospinal fluid EV71 antibody levels were measured and the sensitivity of the EV71 antibody was predicted by the receiver operating characteristic curve （ROC）. Specificity, and logistic multivariate regression analysis was used to evaluate the effect of serum EV71 antibody on severe HFMD complicated with encephalitis. Results The level of EV71 antibody in serum and cerebrospinal fluid in patients with bacterial encephalitis and viral encephalitis was higher than that in unrelated encephalitis control group [serum EV71 antibody （μg/L）： 403.5±19.6, 397.1±20.8 vs. 115.9±32.4, cerebrospinal fluid EV71 antibody （P 〈 0.05）, while the levels of EV71 antibody in the serum and cerebrospinal fluid of the bacterial encephalitis group and the viral encephalitis group were significantly higher than those in the control group （P 〈 0.05）, and the difference was statistically significant （P 〈 0.05）. The difference was not statistically significant （P 〉 0.05）. ROC curve showed that cerebrospinal fluid and serum EV71 antibody predicted the sensitivity （87.83%, 85.16%） and specificity （90.52%, 89.33%） of severe HFMD complicated encephalitis respectively （all P 〈 0.05）. Multivariate logistic regression analysis showed that the influencing factors of cerebrospinal fluid and serum EV71 antibody were statistically significant （P 〈 0.05）. Conclusions Severe HFMD complicated with encephalitis can damage the brain tissue of children, and cause cerebrospinal fluid, serum EV71 antibody lev

关 键 词：脑脊液EV71抗体 重症手足口病 脑炎 预测价值 

分 类 号：R446.6[医药卫生—诊断学] R725.1[医药卫生—临床医学]