血清淀粉样蛋白A在不同类型手足口病急性期中应用.docVIP

血清淀粉样蛋白A在不同类型手足口病急性期中应用 　　[摘要] 目的 探讨血清淀粉样蛋白A（SAA）在手足口病急性期轻症患儿、危重症[包括肠道病毒71型 （Enterovirus 71，EV 71）、柯萨奇病毒A组16（Coxsackievirus A 16，CoxA 16）型]感染患?褐械恼锒霞壑怠? 方法 选取2015 年7～12月间轻症手足口患儿442例，危重症患儿85例，其中包括EV71感染患儿57例、CoxA16感染患儿28例，入院24 h内检测各组患儿SAA水平，并进行统计学对比分析。 结果 轻症组手足口病患儿SAA水平显著高于危重症组， 差异有统计学意义（P0.05）。 结论 SAA在手足口病患儿急性期明显升高，而且在CoxA16组、EV71组中升高低于轻症组。SAA在儿童手足口病的辅助诊断、轻重症的早期鉴别诊断以及治疗中起到重要作用，值得临床广泛应用。 　　[关键词] 手足口病；血清淀粉样蛋白A；EV71；CoxA16 　　[中图分类号] R363 [文献标识码] B [文章编号] 1673-9701（2017）32-0043-03 　　[Abstract] Objective To investigate the diagnostic value of serum amyloid A（SAA） in the children with mild acute hand-foot-mouth disease， critical illness[including enterovirus type 71（EV 71）， and Coxsackievirus type A 16 （CoxA 16）]. Methods From July to December 2015， 442 children with mild hand-foot-mouth disease and 85 critically ill children were selected， including 57 children with EV71 infection， and 28 children with CoxA16 infection. The level of SAA in each group was detected within 24 hours after admission， and statistically comparative analysis was performed. Results The level of SAA in children with mild hand-foot-mouth disease was significantly higher than that in critically ill group， and the difference was statistically significant（P0.05）. Conclusion SAA in children with hand-foot-mouth disease in the acute phase is significantly increased， and the increase in the CoxA16 group and EV71 group is lower than the mild group. SAA plays an important role in the adjuvant diagnosis of hand-foot-mouth disease in children， as well as in the early differentiated diagnosis and treatment of mild and severe diseases， which is worthy of widespread clinical application. 　　[Key words] Hand-foot-mouth disease； Serum amyloid A； EV71； CoxA16 　　手足口病（hand-foot-mouth disease，HFMD）是由多种肠道病毒感染引起的夏秋季常见儿童传染病[1]。临床可分为5期：1期为出疹期、2期为神经系统受累期、3期为心肺功能衰竭前期、4期为心肺功能衰竭期、5期为恢复期。手足口病患儿在第1、第2期皆可治愈，但少数患儿会出现合并神经系统损害，病情变化突然，短期内迅速进入第3期，甚至导致死亡[2]。重症病例多由肠道病毒EV71型（EV71）、柯萨奇病毒A组16（CoxA16）感染引起，病情较凶险，病死率较高，尤以EV71为重，重症多发生于3