血清前清蛋白和胆碱酯酶测定对重症手足口病合并脑炎患儿的临床意义研究.pdf

Chinese General Practic
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手足口病专栏?
编者按』手足口病是一种儿量传染病,多发生于5岁以下儿童,可引起手、足、口腔等部位的疱渗,少数患儿
可引起心肌炎、肺水肿、无茵性脑膜脑芡等并发症,重症患儿病情发展快,可导致死亡。手足口病的诊断主要包括临
床表现和实验室检查,其治疗包括抗病毒、抗感染、免疫调节和支持疗法等。本期专栏探讨血清前清蛋白和胆藏酯酶
测定对重症手足口病合并脑炎赵儿的临床意义,两种球蛋白及干扰素治泞的临床疗效,石家庄市气象因素与手足口病
流行的关系,为临床医生诊断、治疗和预防手足口病提供参考。
血清前清蛋白和胆碱酯酶测定对重症手足口病合并脑炎患儿的
临床意义研究
高伟,安红,张少丹
【摘要】目的探讨血清前清蛋白(PA)和胆碱酯酶(CHE)测定对重症手足口病合并脑炎患儿中的临床意
义。方法选取2010年4-7月我院收住院治疗的手足口病患儿82例,根据病情程度分为:重症合并脑炎组52例,
普通组30例;另选取同时期体检正常儿25例为对照组。检涮患儿入院后12h、治泞后7d和对照组体检时血清PA、
CHE的水平。结果入院12h3组血清PA水平比較,差异有统计学意义(P<0.05);其中两两比较差异均有统计学
意义(P<0.05)。入院12h3組血清CHE水平比較,差异无统计学意义(P>0.05)。治疗后7d3组血清PA、CHE
水平比較,差异均无统计学意义(P>0.05)。结论动态观察血清PA水平的变化,对于重症手足口病合并脑炎患儿
可作为判断其诊断、疗效及预后的重要指标之一,而CHE的变化则无意义。
【关键词)】手足口病;脑炎;前清蛋白;胆碱酯酶类
【中图分类号】R725.125.7【文献标识码】Adoi;10.3969/jisa.1007-9572.2013.01.105
Value of Serum Prealbumin and Cholinesterase el in Pediatric HFMD Combined th Encephalitis GAO Wei, AN
Hong, ZHANG Shao-dan Peoples Hospital of Xingtai, Xingtai 054001, China
(Abstract] Objective To investigate the clinical significance of serum prealbumin(PA) and cholinesterase( CHE)
in children with severe hand, foot and mouth disease(HFMD combine with nepali is Methods 82 HFMD children admit
ted to our hospital from April to July in 010 were divided into HFMD combined with encephalitis group(52 cases )and noma
group( 30 cases) . Another 25 healthy children underwent physical examination in the same period were selected as control
group. The serum PA and CHE levels of HFMD children and healthy children 12 h after admission, 7 d after treatment were detec
ted. Results The serum PA 12 h after admission between the three groups showed statistically significant difference(P<0.5)
and showed statistically significant differences pairwise as well(P<0. 05) While the serum CHE 12 h after admission between
the three roups showed no statistically significant difference(P> 0.05). The PA and CHE levels after 7d treatment between the
three groups showed no statistically significant dif erence(P>O.5).Conclusion Dynamic observation of serum PA level
changes can be used as an important indicator to determine the diagnosis, curative effect and prognosis of severe hand, foot and
mouth disease combined with encephalitis. CHE changes have no significant meaning
(Key words) Hand, foot and mouth disease; Encephalitis; Prealbumin; Cholinesterases
手足口病(hand-foot- mouth disease,HFMD)是由多种成为关键。研究提示,机体在重症HFMD期间,会出现很多
肠道病毒( human enterovirus,EV)引起的一组以手、足、臀急性时相蛋白的变化,其中血清前清蛋白(PA)、胆碱酯酶
部及口腔黏膜等部位的皮疹、疱疹或疱疹性咽峡炎,伴发热、(CHE)常被用作肝脏疾病以及感染性疾病较敏感的指标,某
或不伴发热为特征的儿科多发传染病口。5岁以下儿童多见,些疾病,比如脓毒症以及一些恶性肿瘤在病情危重期间,在
婴幼儿尤重,少数重症病例可并发脑炎或心肌炎及肺水肿等,CE活力降低的同时,发现PA水平也有所下降,而且二者变
合并脑炎是导致HMD患儿死亡的重要原因之一,因此探素化成正相关。本研究观察重症HPMD合并脑炎患儿急性期
发现重症HFMD的早期、快速、准确的预警以及诊断方法就及恢复期血清PA及CHE水平的变化,探讨其在发病过程中
的变化特点,及其对预后的影响。
资料与方法
作者单位:054001河北省邢台市人民医院儿科(高伟,安红);
1纳入标准均符合卫生部颁发的《医疗机构手足口诊疗
河北医科大学附属第二医院(张少丹
技术指南》,(1)普通病例诊断标准:手、足、臀部及口腔黏