外周血AngⅡ、SAA/CRP、HMGB1水平对危重症手足口病的早期诊断价值及其与EWS评分的相关性分析  

Value of peripheral blood AngⅡ,SAA/CRP and HMGB1 levels in the early diagnosis of critical hand-foot-mouth disease and their correlation with EWS score

作　　者：息华丽 边朋 XI Huali;BIAN Peng(Department of Pediatrics,Hengshui Second People′s Hospital,Hengshui,Hebei 053000,China;Department of Pediatrics,General Hospital of Jizhong Energy Fengfeng Group Co.,Ltd,Handan,Hebei 056000,China)

机构地区：[1]河北省衡水市第二人民医院儿科,河北衡水053000 [2]冀中能源峰峰集团有限公司总医院儿科,河北邯郸056000

出　　处：《国际检验医学杂志》2022年第20期2481-2484,2490,共5页International Journal of Laboratory Medicine

基　　金：河北省医学科学研究课题计划(20201262)。

摘　　要：目的探讨外周血血管紧张素Ⅱ(AngⅡ)、淀粉样蛋白A/C反应蛋白(SAA/CRP)、高迁移率族蛋白B1(HMGB1)水平诊断危重症手足口病的价值及其与早期预警系统(EWS)评分的相关性。方法选取2020年3月至2021年6月衡水市第二人民医院收治的112例手足口病患儿作为研究对象,其中普通43例,重症41例,危重症28例。比较不同病情严重程度患儿的临床资料及外周血AngⅡ、SAA/CRP、HMGB1水平,分析外周血AngⅡ、SAA/CRP、HMGB1水平与EWS评分的相关性及其对危重症手足口病的诊断价值,并分析外周血AngⅡ、SAA/CRP、HMGB1水平与危重症手足口病发病风险的关系。结果危重症患儿EWS评分均高于重症和普通患儿,重症患儿又高于普通患儿,差异均有统计学意义(P<0.05);危重症患儿外周血AngⅡ、SAA/CRP、HMGB1水平均高于重症和普通患儿,重症患儿又高于普通患儿,差异均有统计学意义(P<0.05);危重症手足口病患儿外周血AngⅡ、SAA/CRP、HMGB1水平与EWS评分均呈正相关(P<0.05);外周血AngⅡ、SAA/CRP、HMGB1水平诊断危重症手足口病的受试者工作特征曲线下面积(AUC)分别为0.749、0.709、0.750,3项指标联合检测诊断的AUC最大,为0.851;外周血AngⅡ、SAA/CRP、HMGB1水平升高均会明显增加危重症手足口病发病的风险(P<0.05)。结论外周血AngⅡ、SAA/CRP、HMGB1水平对危重症手足口病的早期诊断具有一定价值,并且与患儿EWS评分均呈正相关。Objective To explore the value of peripheral blood angiotensinⅡ(AngⅡ),amyloid A/C reactive protein(SAA/CRP),high mobility group protein B1(HMGB1)levels in the diagnosis of critical hand-foot-mouth disease and their correlation with early warning system(EWS)score.Methods A total of 112 children with hand-foot-mouth disease in Hengshui Second People′s Hospital from March 2020 to June 2021 were selected as research objects,of which 43 cases were common type,41 cases were severe type,and 28 cases were critical type.The clinical data,peripheral blood AngⅡ,SAA/CRP,HMGB1 levels of children with different disease severity were compared,the correlation between the peripheral blood AngⅡ,SAA/CRP,HMGB1 levels and the EWS score and the diagnostic value for critical hand-foot-mouth disease were analyzed,and the relationship between the levels of AngⅡ,SAA/CRP,HMGB1 in peripheral blood and the risk of critical hand-foot-mouth disease was analyzed.Results The EWS score in children with critical type was higher than those in children with severe and common types,and that in children with severe type was higher than that in children with common type,and the differences were statistically significant(P<0.05).The peripheral blood AngⅡ,SAA/CRP and HMGB1 levels in children with critical type were higher than those in children with severe and common types,and those in children with severe type was higher than those in children with common type,and the differences were statistically significant(P<0.05).The peripheral blood AngⅡ,SAA/CRP,HMGB1 levels in children with critical type positively correlated with EWS score(P<0.05).The area under the receiver operating characteristic curve(AUC)of peripheral blood AngⅡ,SAA/CRP,and HMGB1 for the diagnosis of critical hand-foot-mouth disease were 0.749,0.709,and 0.750,respectively.The AUC of the combined detection of three indexes was the largest,which was 0.851.The elevated levels of AngⅡ,SAA/CRP and HMGB1 in peripheral blood could significantly increase the risk of critical han

关 键 词：手足口病 血管紧张素Ⅱ 淀粉样蛋白A C反应蛋白 高迁移率族蛋白B1 早期预警系统评分 

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