重症手足口病患儿血清NSE及S-100β检测意义

发布时间：2018-05-04 16:39

本文选题：手足口病 + 脑炎　；参考：《福建医科大学》2014年硕士论文

【摘要】：目的探讨手足口病(Hand-foot-mouth Disease,HFMD)患儿血清神经元特异性烯醇化酶(neuron-specific enolase,NSE)及Sangtec-100β(S-100β)蛋白和脑损伤的关系。方法连续入院2014年3月至2014年8月在泉州儿童医院住院治疗的HFMD患儿137例,按照2010年版卫生部印发的《手足口病诊疗指南》的临床诊断标准,根据临床症状及体征,将患儿分危重型组(n=15)、重型组(n=68)、普通组(n=54)。设同期健康体检儿对照组(n=20)。在病情急性期(即入院24小时内)进行腰椎穿刺检查脑脊液细胞学和生化,抽取静脉血采用电化学免疫发光法测定患儿NSE及S-100β蛋白,同时记录患儿年龄、性别、颅脑MRI、血白细胞计数、血糖、谷丙转氨酶、血肌酐等。结果1.危重型组、重型组和普通组在性别、年龄、血白细胞计数、谷丙转氨酶、血肌酐方面无统计学显著性差异(P0.05),危重型组血糖显著高于其他三组血糖(P0.05)。2.血清NSE检测结果:危重型组和重型组NSE显著高于普通组和对照组NSE(P0.05),危重型组和重型组之间NSE差异有统计学意义(P0.05),普通组和对照组之间NSE差异无统计学意义(P0.05)。3.血清S-100β蛋白检测结果:危重型组和重型组S-100β显著高于普通组和对照组S-100β(P0.05),危重型组和重型组之间S-100β差异有统计学意义(P0.05),普通组和对照组之间S-100β差异无统计学意义(P0.05)。4.危重型患儿颅脑MRI可见不同程度脑损伤,监测血清NSE及S-100β蛋白数值可间接评估HFMD合并脑炎及脑损伤的严重程度,并根据数值判断预后情况。结论根据不同组别血清NSE及S-100β蛋白的含量检测情况,可见危重型组NSE及S-100β浓度显著高于重型组、普通组及对照组,提示血清NSE及S-100β蛋白的升高说明患儿存在神经系统的损害,并且与病情的严重程度呈正相关。
[Abstract]:Objective to investigate the relationship between serum neuron-specific enolase (NSE) and Sangtec-100 尾 -S-100 尾 protein and brain injury in children with Hand-foot-mouth disease (Hand-foot-mouth disease). Methods from March 2014 to August 2014, 137 patients with HFMD were hospitalized in Quanzhou Children's Hospital. According to the clinical diagnosis criteria of hand, foot and mouth disease issued by the Ministry of Health in 2010, according to the clinical symptoms and signs, 137 cases of HFMD were hospitalized in Quanzhou Children's Hospital from March 2014 to August 2014. The children were divided into critical group (n = 15), severe group (n = 68) and common group (n = 54). At the same time, the control group of healthy children was established. Cerebrospinal fluid (CSF) cytology and biochemistry were examined during the acute phase of the disease (i.e. within 24 hours of admission). The NSE and S-100 尾 protein were determined by electrochemiluminescence (ECL) in venous blood samples, and the age and sex of the patients were recorded. Craniocerebral MRI, white blood cell count, blood glucose, alanine aminotransferase, serum creatinine, etc. Result 1. There was no significant difference in sex, age, white blood cell count, glutamic-pyruvic transaminase and serum creatinine between the critical group, the severe group and the normal group (P 0.05), but the blood glucose in the critical type group was significantly higher than that in the other three groups (P 0.05). The results of serum NSE detection: NSE in critical and severe group was significantly higher than that in normal group and control group (P 0.05). There was significant difference in NSE between critical group and severe group (P 0.05). There was no significant difference in NSE between normal group and control group (P 0.05). The results of serum S-100 尾 protein detection showed that S-100 尾 was significantly higher in critical and severe group than that in normal group and control group. There was a significant difference in S-100 尾 between critical group and severe group (P 0.05), but there was no significant difference in S-100 尾 between normal group and control group (P 0.05 路4). Brain MRI showed different degrees of brain injury in critically ill children. Monitoring the values of serum NSE and S-100 尾 protein could indirectly evaluate the severity of HFMD associated with encephalitis and brain injury, and judge the prognosis according to the values. Conclusion according to the detection of serum NSE and S-100 尾 protein in different groups, it can be seen that the concentration of NSE and S-100 尾 in critical type group is significantly higher than that in severe group, common group and control group, suggesting that the increase of serum NSE and S-100 尾 protein may indicate the nervous system damage in children. There was a positive correlation between the severity of the disease and the severity of the disease.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R725.1

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