血清VEGF、TNF-α、CRP、SAA诊断手足口病合并脑炎的价值分析  

Analysis on value of serum VEGF, TNF-α, CRP and SAA in diagnosis of HFMD with encephalitis

作　　者：刘文田 唐芳华 刘玉花 张琳 史桂香 王红 Liu Wentian;Tang Fanghua;Liu Yuhua;Zhang Lin;Shi Guixiang;Wang Hong(Laboratory Department,Yanshan People's Hospital,Cangzhou,Hebei,061300,China;Laboratory Department,Hebei Gaobeidian Hospital,Baoding,Hebei,074000,China;Laboratory Department,Hospital 980 of PLA Joint Logistics Support Forces,Shijiazhuang,Hebei,050000,China)

机构地区：[1]河北省盐山县人民医院检验科,河北沧州061300 [2]河北省高碑店市医院检验科 [3]解放军980医院检验科

出　　处：《西南国防医药》2021年第6期465-469,共5页Medical Journal of National Defending Forces in Southwest China

基　　金：河北省沧州市科技局重点研发计划指导项目(192106016)。

摘　　要：目的探讨血清血管表皮生长因子(VEGF)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、淀粉样蛋白A(SAA)诊断EV71感染手足口病患儿合并脑炎的价值。方法选择2019年8月~2020年2月河北省盐山县人民医院收治的362例EV71感染手足口病患儿,其中126例合并脑炎(脑炎组),236例未合并脑炎(对照组)。检测血清VEGF、TNF-α、CRP、SAA水平,收集患儿临床资料,多元Logistic回归分析VEGF、TNF-α、CRP、SAA与EV71感染手足口病患儿合并脑炎的关系。受试者工作特征曲线(ROC)分析VEGF、TNF-α、CRP、SAA诊断EV71感染手足口病患儿合并脑炎的价值。结果脑炎组血清VEGF、TNF-α、CRP、SAA水平高于对照组(P <0.05),血清TNF-α、CRP、SAA水平与VEGF均呈正相关(r=0.630、0.713、0.867,P <0.05)。VEGF、TNF-α、CRP、SAA是EV71感染手足口病患儿合并脑炎的危险因素(P <0.01)。VEGF、TNF-α、CRP、SAA预测EV71感染手足口病患儿合并脑炎的曲线下面积(AUC)分别为0.766、0.714、0.651、0.671、0.869。结论血清VEGF、TNF-α、CRP、SAA水平与EV71感染手足口病患儿合并脑炎密切相关,联合4项指标可较为敏感的预测EV71感染手足口病患儿脑炎的发生。Objective To investigate the value of serum VEGF, TNF-α, CRP and SAA in the diagnosis of encephalitis in children with EV71-infected hand-foot-mouth disease(HFMD). Methods A total of 362 children with EV71-infected HFMD admitted in Yanshan People’s Hospital between August 2019 and February 2020 were enrolled in the study, wherein 126 cases with encephalitis were divided into the encephalitis group and 236 cases free from encephalitis were divided into the control group. The levels of VEGF, TNF-α, CRP and SAA in serum were measured, and the clinical data of children were collected. The relationship between VEGF, TNF-α, CRP, SAA and encephalitis in children with EV71-infected HFMD was analyzed by multiple logistic regression. The value of VEGF, TNF-α, CRP and SAA in the diagnosis of encephalitis in children with EV71-infected HFMD was analyzed with ROC. Results The encephalitis group recorded higher levels of VEGF, TNF-α, CRP and SAA than that of the control group(P < 0.05). The levels of TNF-α, CRP and SAA were positively correlated with VEGF(r=0.630, 0.713, 0.867, P < 0.05). VEGF,TNF-α, CRP and SAA were risk factors of encephalitis in children with EV71-infected HFMD(P < 0.01). The AUC of EV71-infected HFMD children complicated with encephalitis predicted by VEGF, TNF-α, CRP and SAA was respectively 0.766, 0.714, 0.651, 0.671 and 0.869. Conclusion The levels of VEGF, TNF-α, CRP and SAA in serum are closely related to encephalitis in EV71-infected HFMD children. The combination of these four indexes can sensitively predict the encephalitis among EV71-infected HFMD children.

关 键 词：VEGF TNF-Α CRP SAA EV71 手足口病 脑炎 诊断分析 

分 类 号：R725.1[医药卫生—儿科]