不同肠道病毒感染引起的手足口病患儿血清学指标及临床特征  

Serological Indexes and Clinical Characteristics of Children With Hand-Foot-Mouth Disease Caused by Different Enterovirus Infection

作　　者：余凌 胡静 游权卜 YU Ling;HU Jing;YOU Quanbu(Department of Infection,Guiyang Public Health Clinical Center,Guizhou Guiyang 550001,China)

机构地区：[1]贵阳市公共卫生救治中心感染科,贵州贵阳550001

出　　处：《中国卫生标准管理》2025年第5期15-18,共4页China Health Standard Management

摘　　要：目的探究不同肠道病毒感染引起的手足口病患儿血清白细胞介素-6(interleukin-6,IL-6)、神经元特异性烯醇化酶(neuron-specific enolase,NSE)、C反应蛋白(C-reactive protein,CRP)的临床意义。方法选取2021年1月—2023年12月在贵阳市公共卫生救治中心感染二科住院的1151例手足口病患儿作为研究对象。对所有手足口病患儿进行肠道病毒检测。根据患儿的肠道病毒检测结果将其分为肠道病毒通用型(Enterovirus,EV)感染组(n=817)、肠道病毒71型(Enterovirus 71,EV71)感染组(n=223)、肠道病毒柯萨奇病毒16型(Coxsackievirus A16,CoxA16)型感染组(n=111);以及同期入院诊断为急性呼吸道感染的患儿作为对照组(n=176)。比较4组患儿的一般资料,包括患儿的性别、年龄、病程以及疾病严重程度等。观察4组患儿的一般资料并分析不同肠道病毒感染引起手足口病患儿血清IL-6、NSE、CRP指标水平差异。根据手足口病患儿的疾病严重程度将其分为轻症组(n=863)和重症组(n=288),分析血清NSE水平与患儿脑病情严重程度。再以手足口病患儿的预后情况为依据,将其分为良好组(n=910)和不良组(n=417),并分析血清NSE水平与患儿预后的相关性。结果4组患者年龄、性别、病程比较,差异无统计学意义(P>0.05);4组IL-6、NSE及CRP比较,差异有统计学意义(F=584.360,P<0.001;F=907.041,P<0.001;F=60.133,P<0.001);EV型感染组、EV71型感染组、CoxA16型感染组疾病严重程度比较,差异有统计学意义(χ^(2)=23.854,P<0.001)。重症组患儿血清NSE水平为(41.39±5.69)ng/mL,高于轻症组的(27.62±1.76)ng/mL,差异有统计学意义(t=25.330,P<0.001);Kendall分析结果显示,血清NSE水平与手足口病患儿重症呈正相关关系(rs=0.382,95%CI=0.326~0.433,SE=0.027,P<0.001);与良好组血清NSE水平(13.25±1.24)ng/mL相比,不良组患儿的血清NSE水平(29.44±2.68)ng/mL更高,差异有统计学意义(t=140.156,P<0.001);Kendall分析结果显示,血清NSE水�Objective To investigate the clinical significance of serum interleukin-6(IL-6),neuron-specific enolase(NSE),C-reactive protein(CRP)and NSE in hand,foot and mouth disease caused by different enterovirus infections.Methods From January 2021 to December 2023,1151 children with hand,foot and mouth disease who were hospitalized in the second department of infection of Guiyang Public Health Clinical Center were selected as the research objects.Enterovirus testing was performed on all children with hand,foot and mouth disease.The children were categorized into Enterovirus(EV)type infection group(n=817),Enterovirus 71(EV71)type infection group(n=223),and Coxsackievirus A16(CoxA16)type infection group(n=111)based on the results of enterovirus testing;and children diagnosed with acute respiratory infections admitted to the hospital during the same period served as the control group(n=176).The general data of the children in the four groups were compared,including the gender,age,duration of disease and severity of disease.The general data of the four groups and analyze the differences in serum IL-6,NSE,and CRP levels among children with hand,foot and mouth disease caused by different enteroviral infections.According to the severity of hand,foot and mouth disease,the children were divided into the mild group(n=863)and the severe group(n=288),and the serum NSE levels were analyzed in relation to the severity of the children's cerebral disease.Based on the prognosis of the children with hand,foot and mouth disease,they were also divided into the good group(n=910)and the bad group(n=417),and the correlation between serum NSE levels and the prognosis of the children was analyzed.Results There were no significant differences between the four groups in the comparison of age,gender,disease duration and other general data(P>0.05);IL-6,NSE and CRP were significantly different among the four groups(F=584.360,P<0.001;F=907.041,P<0.001;F=60.133,P<0.001).There was significant difference in disease severity among EV infection group,EV71

关 键 词：柯萨奇病毒16型 肠道病毒71型 肠道病毒通用型 感染 手足口病 预后 血清学指标 

分 类 号：R511[医药卫生—内科学]