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目的通过检测手足口病(HFMD)患儿血清降钙素原(PCT)、C反应蛋白(CRP)、白介素-6(IL-6)及白介素-10(IL-10)水平,探讨其临床意义。方法采用电化学发光法检测126例HFMD患儿及30例正常对照儿童血清PCT水平;采用免疫速率散射比浊法检测126例患儿及30例正常儿童血清CRP水平;用酶联免疫吸附试验(ELISA)检测64例HFMD患儿及24例正常对照儿童的血清IL-6、IL-10水平。结果普通病例组的PCT浓度为0.054(0.035～0.080)ng/mL,重症病例组的PCT浓度为0.067(0.043～0.119)ng/mL,正常对照组为0.037(0.026～0.044)ng/mL,各组差异有统计学意义(H=26.678,P=0.000);普通病例组的CRP浓度为1.950(1.100～3.575)ng/mL,重症病例组的CRP浓度为2.450(1.100～12.075)ng/mL,正常对照组为1.600(1.075～2.550)ng/mL,重症病例组高于正常对照组(Z=-2.081,P=0.037);PCT、CRP、IL-6和IL-10重症病例组与普通病例组间差异无统计学意义(Z=-1.865,P=0.062;Z=-1.707,P=0.088;Z=-1.396,P=0.163;Z=-0.951,P=0.342);126例HFMD患儿中,PCT阳性率为60.32%,CRP阳性率为15.08%,PCT和CRP在HFMD患儿中阳性率均升高(P≤0.05),PCT阳性率明显高于CRP(P<0.001)。结论血清PCT可作为HFMD患儿炎症性参考指标,反映HFMD免疫性炎症改变。
Objective To investigate the clinical significance of serum procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6) and interleukin-10 (IL-10) in children with HFMD . Methods Electrochemical chemiluminescence was used to detect serum PCT levels in 126 HFMD children and 30 normal controls. Serum CRP levels were measured in 126 children and 30 normal children by immunostaining nephelometry. The serum levels of CRP were measured by enzyme-linked immunosorbent assay ELISA) was used to detect serum IL-6 and IL-10 levels in 64 HFMD children and 24 normal control children. Results The PCT concentration was 0.054 (0.035 ~ 0.080) ng / mL in the common case group, 0.067 (0.043 ~ 0.119) ng / mL in the severe case group and 0.037 (0.026 ~ 0.044) ng / mL in the normal control group The CRP concentration was 1.950 (1.100 ~ 3.575) ng / mL in the common case group and 2.450 (1.100 ~ 12.075) ng / mL in the severe case group (H = 26.678, P = 0.000) The normal control group was 1.600 (1.075-2.550) ng / mL, the severe case group was higher than the normal control group (Z = -2.081, P = 0.037); the severe cases of PCT, CRP, IL-6 and IL- There was no significant difference between the two groups (Z = -1.865, P = 0.062; Z = -1.707, P = 0.088; Z = -1.396, P = 0.163; Z = -0.951, P = 0.342) The positive rate of PCT was 60.32% and the positive rate of CRP was 15.08%. The positive rates of PCT and CRP in HFMD were all higher (P≤0.05). The positive rate of PCT was significantly higher than that of CRP (P <0.001). Conclusions Serum PCT can be used as an inflammatory reference index in HFMD children, reflecting the change of HFMD autoimmune inflammation.