CA6型手足口病脑炎患儿血清IL-6、HLA-DR mRNA联合检测的临床意义  

Clinical significance of combined detection of serum IL-6 and HLA-DR mRNA in children with CA6 hand-foot-mouth disease encephalitis

作　　者：刘晶晶[1] 周秀芬 LIU Jing-Jing;ZHOU Xiu-Fen(Infectious Diseases Department,Liaocheng People′s Hospital,Liaocheng 252000,China)

机构地区：[1]聊城市人民医院感染科,聊城252000 [2]聊城市传染病医院内科,聊城252000

出　　处：《中国免疫学杂志》2020年第4期491-494,共4页Chinese Journal of Immunology

摘　　要：目的:探讨血清IL-6、HLA-DR mRNA联合检测在CA6型手足口病脑炎中的临床意义。方法:采用随机抽样的方法选取2018年4月至2018年8月在山东省聊城市人民医院感染科住院治疗的CA6型手足口病脑炎患儿30例,为手足口病脑炎组。纳入同期门诊的CA6型无并发症的手足口病患儿30例,为手足口病组。入组患儿于入院当天或就诊当天抽取静脉血5 ml,手足口病脑炎组入组患儿入院后1或2 d行腰椎穿刺术,收集脑脊液2 ml。应用ELISA法分别检测IL-6在手足口病脑炎组、手足口病组患儿血清中的水平。应用ELISA法检测IL-6在手足口病脑炎组患儿脑脊液中的水平。应用RT-PCR检测各组血清HLA-DR mRNA的水平。结果:手足口病脑炎组与手足口病组患儿血清IL-6、HLA-DR mRNA比较差异均有统计学意义(t分别为9.925、-10.735,均P<0.05)。手足口病脑炎组血清IL-6与脑脊液IL-6,手足口病脑炎组血清IL-6与手足口病脑炎组脑脊液白细胞计数均呈正相关(r分别为0.867、0.770,均P<0.05)。手足口病脑炎组血清HLA-DR mRNA与脑脊液白细胞计数呈负相关(r=-0.700,P<0.05)。利用血清IL-6及HLA-DR mRNA诊断CA6型手足口病脑炎时ROC曲线下面积分别为0.896(95%可信区间为0.794~0.999)、0.980(95%可信区间为0.954~1.006)。结论:血清IL-6在CA6型手足口病脑炎组明显高于手足口病组,HLA-DR mRNA明显低于手足口病组,差异均有统计学意义。CA6型手足口病脑炎患儿血清IL-6与脑脊液 IL-6、WBC均呈正相关,血清HLA-DR mRNA与脑脊液WBC呈负相关。利用血清IL-6、血清HLA-DR mRNA诊断CA6手足口病脑炎时ROC曲线下面积均>0.5。说明应用血清IL-6、HLA-DR mRNA联合检测在CA6型手足口病脑炎的早期诊断具有临床意义,便于临床早治疗以减少不良后果的发生。Objective:To explore the clinical significance of combined detection of serum IL-6 and HLA-DR in CA6 hand-foot-mouth disease encephalitis.Methods:Thirty children with hand-foot-mouth disease(HFMD)and encephalitis of CA6 type were selected by random sampling from April 2018 to August 2018 in the infectious department of Liaocheng People′s Hospital,Shandong province,as the HFMD encephalitis group.Thirty children with hand-foot-mouth disease(HFMD)of CA6 type without complications were enrolled in the same outpatient clinic as HFMD group.5 ml venous blood was drawn on the day of admission or on the day of consultation.Lumbar puncture was performed on 1 or 2 days after admission to collect 2 ml cerebrospinal fluid.The serum levels of IL-6 in HFMD encephalitis group and HFMD group were detected by ELISA.The level of IL-6 in CSF of Children with HFMD encephalitis was detected by ELISA.The levels of HLA-DR in serum of each group were detected by RT-PCR.Results:There were significant differences in serum IL-6 and HLA-DR mRNA between HFMD encephalitis group and HFMD group(t was 9.925,-10.735,all P<0.05).Serum IL-6 was positively correlated with cerebrospinal fluid IL-6 and white blood cell count in HFMD encephalitis group(r was 0.867 and 0.770,all P<0.05).Serum HLA-DR mRNA was negatively correlated with white blood cell count in cerebrospinal fluid(r=-0.700,P<0.05) in HFMD encephalitis group.The area under ROC curve of serum IL-6 and HLA-DR in diagnosis of CA6 hand-foot-mouth disease encephalitis was greater than 0.5.Conclusion:The combined detection of serum IL-6 and HLA-DR mRNA plays an important role in the early diagnosis of CA6 hand-foot-mouth disease encephalitis and is convenient for early clinical treatment to reduce the occurrence of adverse consequences.

关 键 词：柯萨奇病毒A6 手足口病 脑炎 IL-6 HLA-DR MRNA 

分 类 号：R446.69[医药卫生—诊断学]