分析儿科危重症手足口病诊断中早期预警评分及炎症标志物的意义
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摘要
目的探讨分析儿科危重症手足口病诊断中早期预警评分及炎症标志物的意义。方法随机选取我院在2017年2月-2018年2月就诊的危重症手足口病患儿共100例作为研究组,同时选取100例正常儿童作为对照组,研究分析两组研究对象的WBC、IgA、PCT、Ly、IgG、CRP、NC以及IgM水平和各项检查指标对危重症手足口病的检查效能。结果研究组的WBC水平、PCT水平、Ly水平、CRP水平、NC水平、以及IgM水平高于对照组(P<0.05),研究组的IgA水平、IgG水平低于对照组(P<0.05);PEWS(儿童早期预警评分)ROC曲线下面积为0.984(0.961-1.000),最佳诊断界值PEWS为3.5分,PEWS与PCSI(儿童危重症评分)呈现负相关关系(P<0.05)。结论 WBC、IgA、PCT、Ly、IgG、CRP、NC以及IgM水平等标志物含量可以为儿科危重症手足口病患儿提供临床依据,但是不能作为量化指标使用,PEWS评分是理想的用于诊断儿科危重症手足口病的量化指标。
Objective To explore the early warning scores and the significance of inflammatory markers in the diagnosis of hand-foot-mouth disease in pediatric critical illness.Methods A total of 100 children with critical hand,foot and mouth disease who were treated in our hospital from February to February 2018 in 2017 were randomly selected as the study group.100 normal children were selected as the control group.The WBC and IgA of the two groups were analyzed.,PCT,Ly,IgG,CRP,NC and IgM levels and various indicators to check the efficacy of critical hand,foot and mouth disease.Results The WBC level,PCT level,Ly level,CRP level,NC level,and IgM level of the study group were significantly higher than the control group(P<0.05).The IgA level and IgG water in the study group were significantly lower than the control group(P<0.05).PEWS(Child Early Warning Score)had an area under the ROC curve of 0.984(0.961-1.000),and the best diagnostic cut-off value of PEWS was 3.5.There was a negative correlation between PEWS and PCSI(child critical illness score)(P<0.05).Conclusion Markers such as WBC,IgA,PCT,Ly,IgG,CRP,NC,and IgM levels can provide clinical evidence for children with pediatric critical hand,foot and mouth disease,but cannot be used as a quantitative indicator.PEWS score is ideal for pediatric diagnosis.Quantitative indicators of critical hand,foot and mouth disease.
Objective To explore the early warning scores and the significance of inflammatory markers in the diagnosis of hand-foot-mouth disease in pediatric critical illness.Methods A total of 100 children with critical hand,foot and mouth disease who were treated in our hospital from February to February 2018 in 2017 were randomly selected as the study group.100 normal children were selected as the control group.The WBC and IgA of the two groups were analyzed.,PCT,Ly,IgG,CRP,NC and IgM levels and various indicators to check the efficacy of critical hand,foot and mouth disease.Results The WBC level,PCT level,Ly level,CRP level,NC level,and IgM level of the study group were significantly higher than the control group(P<0.05).The IgA level and IgG water in the study group were significantly lower than the control group(P<0.05).PEWS(Child Early Warning Score)had an area under the ROC curve of 0.984(0.961-1.000),and the best diagnostic cut-off value of PEWS was 3.5.There was a negative correlation between PEWS and PCSI(child critical illness score)(P<0.05).Conclusion Markers such as WBC,IgA,PCT,Ly,IgG,CRP,NC,and IgM levels can provide clinical evidence for children with pediatric critical hand,foot and mouth disease,but cannot be used as a quantitative indicator.PEWS score is ideal for pediatric diagnosis.Quantitative indicators of critical hand,foot and mouth disease.
引文
[1] 郑亚明,杨娟,廖巧红.手足口病重症患者健康相关生存质量评估[J].中华流行病学杂志,2017,38(4):462-466.
[2] Shao P,Wu X,Li H,et al.Clinical significance of inflammatory cytokine and chemokine expression in hand,foot and mouth disease[J].Molecular Medicine Reports,2017,15(5):2859.
[3] 林友青.重症手足口病患儿血清免疫水平的变化情况及其临床意义研究[J].中国临床新医学,2015,8(7):639-641.
[4] Liu,She‐Lan,Pan H,Liu P,et al.Comparative epidemiology and virology of fatal and nonfatal cases of hand,foot and mouth disease in mainland China from 2008 to 2014[J].Reviews in Medical Virology,2015,25(2):115-128.
[5] 黄朋,方恋,陈波,等.重症肺炎患者血清降钙素原、C-反应蛋白、D二聚体及炎症因子水平变化及其临床意义[J].安徽医药,2018,22(3):478-482.
[6] 何新发,李燕妮.PCT、hs-CRP及IL-6对手足口病继发细菌感染诊断价值[J].齐鲁医学杂志,2016(1):77-78.
[7] 王川林,刘娇,古雪,等.血清炎症因子水平在血流感染性疾病中的表达及与病原菌、病情程度及预后的相关性研究[J].中国现代医学杂志,2017,27(21):61-65.
[8] Xiong Y,Wang J,Wei D,et al.Early diagnosis value of serum neuron-specific enolase and CRP in hand-foot-mouth disease complicating encephalitis[J].Chongqing Medicine,2016,34(2):243-245.
[9] 韩雪,程江,左维泽,等.感染指标在手足口病早期合并细菌感染的诊断价值[J].实用医学杂志,2016,32(6):996-998.
[10] 张薇,羊玲,钟丽花,等.血清降钙素原对手足口病患儿伴细菌感染的早期鉴别诊断价值[J].中华医院感染学杂志,2016,26(5):1143-1145.
[11] 汤昔康,李庆彦,李汝霞,等.手足口病合并细菌感染的临床特征与免疫功能变化研究[J].中华医院感染学杂志,2016,26(20):4721-4723.
[12] 戴桂凤.儿童早期预警评分在门诊手足口病患儿分流及病情评估中的应用[J].医学理论与实践,2017,30(13):1897-1899.
[2] Shao P,Wu X,Li H,et al.Clinical significance of inflammatory cytokine and chemokine expression in hand,foot and mouth disease[J].Molecular Medicine Reports,2017,15(5):2859.
[3] 林友青.重症手足口病患儿血清免疫水平的变化情况及其临床意义研究[J].中国临床新医学,2015,8(7):639-641.
[4] Liu,She‐Lan,Pan H,Liu P,et al.Comparative epidemiology and virology of fatal and nonfatal cases of hand,foot and mouth disease in mainland China from 2008 to 2014[J].Reviews in Medical Virology,2015,25(2):115-128.
[5] 黄朋,方恋,陈波,等.重症肺炎患者血清降钙素原、C-反应蛋白、D二聚体及炎症因子水平变化及其临床意义[J].安徽医药,2018,22(3):478-482.
[6] 何新发,李燕妮.PCT、hs-CRP及IL-6对手足口病继发细菌感染诊断价值[J].齐鲁医学杂志,2016(1):77-78.
[7] 王川林,刘娇,古雪,等.血清炎症因子水平在血流感染性疾病中的表达及与病原菌、病情程度及预后的相关性研究[J].中国现代医学杂志,2017,27(21):61-65.
[8] Xiong Y,Wang J,Wei D,et al.Early diagnosis value of serum neuron-specific enolase and CRP in hand-foot-mouth disease complicating encephalitis[J].Chongqing Medicine,2016,34(2):243-245.
[9] 韩雪,程江,左维泽,等.感染指标在手足口病早期合并细菌感染的诊断价值[J].实用医学杂志,2016,32(6):996-998.
[10] 张薇,羊玲,钟丽花,等.血清降钙素原对手足口病患儿伴细菌感染的早期鉴别诊断价值[J].中华医院感染学杂志,2016,26(5):1143-1145.
[11] 汤昔康,李庆彦,李汝霞,等.手足口病合并细菌感染的临床特征与免疫功能变化研究[J].中华医院感染学杂志,2016,26(20):4721-4723.
[12] 戴桂凤.儿童早期预警评分在门诊手足口病患儿分流及病情评估中的应用[J].医学理论与实践,2017,30(13):1897-1899.
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