血浆HMGB1及D-二聚体水平在EV71感染手足口病患儿病情判断及预后评估中的价值  

Value of plasma HMGB1 and D-dimer levels in the disease condition judgment and prognosis evaluation of children with EV71-infected hand-foot-and-mouth disease

作　　者：冯韬[1] 付天明[2] FENG Tao;FU Tian-ming(Department of Pediatrics,Longquanyi District of Chengdu Maternity and Child Health Care Hospital,Chengdu 610100,Sichuan,China;Department of Obstetrics and Gynecology,Longquanyi District of Chengdu Maternity and Child Health Care Hospital,Chengdu 610100,Sichuan,China)

机构地区：[1]成都市龙泉驿区妇幼保健院儿科,四川成都610100 [2]成都市龙泉驿区妇幼保健院妇产科,四川成都610100

出　　处：《川北医学院学报》2023年第8期1049-1052,共4页Journal of North Sichuan Medical College

基　　金：四川省卫生健康科研项目(19PJ028)。

摘　　要：目的:探讨血浆高迁移率族蛋白B1(HMGB1)及D-二聚体水平在肠道病毒型71(EV71)感染手足口病(HFMD)患儿中的表达及意义。方法:收集205例EV71感染HFMD患儿作为HFMD组,根据病情分为轻症组(n=96)、重症组(n=64)和危重症组(n=45);另选62名健康儿童作为对照组。比较HFMD组与对照组血浆HMGB1及D-二聚体水平,对比HFMD组不同病情程度血浆HMGB1及D-二聚体水平差异,并分析上述指标与疾病的相关性。对患儿进行随访,采用受试者工作曲线(ROC)分析血浆HMGB1及D-二聚体水平对预测EV71感染HFMD患儿预后的临床价值。结果:HFMD组入院后体温超过39℃且持续时间>3 d的例数、HMGB1、D-二聚体水平均高于对照组(P<0.05);各组血浆HMGB1及D-二聚体水平比较:轻症组<重症组<危重症组(P<0.05);Spearman分析显示,EV71感染HFMD患儿血浆HMGB1及D-二聚体水平与病情程度均呈正相关(P<0.05);随访1个月,EV71感染HFMD患儿中,痊愈185例,有20例存在后遗症,痊愈组患儿血浆HMGB1及D-二聚体水平均低于后遗症组(P<0.05);ROC曲线显示,血浆HMGB1、D-二聚体水平及二者联合对预测EV71感染HFMD患儿预后的曲线下面积(AUC)分别为0.721、0.762、0.800(P<0.05),联合预测价值更高。结论:EV71感染HFMD患儿血浆HMGB1及D-二聚体水平与其疾病严重程度及预后相关,具有一定临床参考价值。Objective:To explore the expressions and significance of plasma high mobility group box protein B1(HMGB1)and D-dimer levels in children with enterovirus 71(EV71)-infected hand-foot-and-mouth disease(HFMD).Methods:205 children with EV71-infected HFMD were selected as HFMD group,and they were divided into mild group(n=96),severe group(n=64)and critically ill group(n=45)according to the disease condition.Another 62 healthy children were enrolled as control group.The levels of plasma HMGB1 and D-dimer were compared between HFMD group and control group.The differences in plasma HMGB1 and D-dimer levels in HFMD group with different disease severities were analyzed,and the correlation between the above indicators and the disease was analyzed.The children were followed up,and Receiver operating characteristics curve(ROC)was used to analyze the clinical value of plasma HMGB1 and D-dimer levels on predicting the prognosis of children with EV71-infected HFMD.Results:The number of patients with body temperature over 39°C and duration of more than 3 d after admission and levels of HMGB1 and D-dimer were higher in HFMD group than those in control group(P<0.05).Plasma HMGB1 and D-dimer levels were shown as mild group<severe group<critically ill group(P<0.05).Spearman analysis showed that the levels of plasma HMGB1 and D-dimer in children with EV71-infected HFMD were positively correlated with the severity of disease(P<0.05).After 1 month of follow-up,185 cases of children with EV71-infected HFMD were cured and 20 cases had sequelae.Plasma levels of HMGB1 and D-dimer in cured group were lower than those in sequelae group(P<0.05).ROC curve revealed that the AUCs of plasma HMGB1,D-dimer and the combination of the two on predicting the prognosis of children with EV71-infected HFMD were 0.721,0.762 and 0.800,respectively(P<0.05),and the combined predictive value was higher.Conclusion:Plasma HMGB1 and D-dimer levels are associated with disease severity and prognosis in children with EV71-infected HFMD,and have clinical reference val

关 键 词：手足口病 肠道病毒型71 高迁移率族蛋白B1 D-二聚体 病情 预后 

分 类 号：R725.1[医药卫生—儿科]