血清S―100β蛋白结合头颅核磁对重症手足口病临床意义.docVIP

血清S―100β蛋白结合头颅核磁对重症手足口病临床意义 　　【摘要】 目的：探讨血清S-100β蛋白结合头颅核磁是否对重症手足口病具有早期识别、判断预后的临床意义。方法：收集2013年5月-2014年5月赣州市妇女儿童医院手足口病病区确诊为手足口病的病例，其中重症手足口病组25例，普通手足口病组25例，无神经系统感染的非手足口病组20例。测定普通手足口病组、重症手足口病组急性期及恢复期血清S-100β蛋白含量及阴性对照组急性期血清S-100β蛋白含量，普通手足口病组、重症手足口病组均进行头颅核磁共振检查。结果：重症手足口病组急性期S-100β蛋白高于阴性对照组，差异有统计学意义（P0.001）。重症手足口病组急性期及恢复期S-100β蛋白均高于普通手足口病组，差异均有统计学意义（P0.001）。发生头颅核磁共振检出异常，重症手足口患者组为72.0%明显高于普通手足口病组的16.0%，两组比较差异有统计学意义（ 字2=15.909，P0.001）。重症手足口患者组发生后遗症为24.0%，普通手足口病组无后遗症发生，两组比较差异有统计学意义（ 字2=4.735，P=0.030）。头颅核磁共振检查异常组的患儿急性期及恢复期S-100β蛋白高于头颅核磁共振无异常病例组，两组比较差异均有统计学意义（P0.001）。头颅核磁共振检查异常组发生后遗症为27.3%，头颅核磁共振无异常组无后遗症发生，两组比较差异有统计学意义（P=0.012）。结论：监测手足口病患儿S-100β蛋白可用于早期判断患儿是否合并中枢神经感染，可早期客观识别是否发展为重症手足口病，血清S-100β蛋白结合头颅核磁共振检查可评估手足口病患儿脑损伤程度及判断预后。 　　【关键词】 S-100β蛋白； 重症手足口病； 早期诊断； 头颅核磁共振； 预后 　　The Clinical Significance of Early Identification of Severe Hand Foot and Mouth Disease by the Serum Levels of S-100βProtein Combined with Cranial Magnetic Resonance/ZHANG Jian，CHEN He，KANG Jian，et al.//Medical Innovation of China，2015，12（26）：014-017 　　【Abstract】 Objective：To investigate the clinical significance of early identification of severe hand foot and mouth disease （HFMD） and its prognosis by the serum levels of S-100β protein combined with cranial magnetic resonance.Method：50 cases diagnosed with HFMD were collected from the women’s and children’s hospital of Ganzhou from May 2013 to May 2014. The effective cases were divided into the common group and the severe group according to clinical manifestations，25 cases in each group. At the same time，20 cases of non HFMD without neurological infections were collected as a negative control group. Serum levels of S-100β protein in acute and recovery stage of severe HFMD group and common HFMD group were detected by the ELISA kit of human S-100β protein. Acute phase serum S-100βprotein was detected in the negative control group. The cranial magnetic resonance was used by the severe HFMD group and common HFMD group.Result：The S-100β protein in acute stage of s