重症手足口病患儿NSE S100β蛋白sVCAM-1和神经肽Y的变化及临床意义

摘要

Objective To observe clinical significance of the levels of s100β protein,neuron specific enzyme (NSE),soluble vascular endothelial cell (sVCAM-1) and neuropeptide Y (YNP-Y) in serum and cerebrospinal fluid (CSF) in children with severe hand-foot-and-mouth disease (HFMD).Methods Sixty patients with severe HFMD were enrolled in this study and were divided into severe group (20 cases) and critical group (40 cases) according to the diagnosis criteria.At the same time thirty ordinary HFMD patients without central nervous system infection were selected as the control group.The levels of NSE and S100β protein in each group were detected by the electrochemical luminescence,the concentration of SVCAM-1 was detected by ELISA and the level of NPY was determined by the radioimmunoassay.All results were statistically analyzed by using V16.0 SPSS software.Results Compared with those in the control group,the levels of NSE,S100β,sVCAM-1 and NPY in both serum and CSF were significantly elevated in severe and critical groups.Furthermore,the critical HFMD group had the higher levels of NSE,S100β,sVCAM-1 and NPY in serum and CSF than the severe HFMD group.All the differences were statistically significant (P<0.05).Conclusion The levels of NSE,S100β,sVCAM-1 and NPY in children with severe hand-foot-and-mouth disease may be related to the severe condition of disease and may evaluate the prognosis,which should be popularized in clinic.%目的 探讨重症手足口病患儿脑脊液及血清中S100β蛋白、神经元烯醇化酶(NSE)、可溶性血管内皮细胞载附分子(sVCAM-1)和神经肽Y(YNP-Y)水平变化及临床意义.方法 60例重症手足口病患儿根据诊断分为重型组(20例)和危重型组(40例),并选取同期我院诊治的无中枢神经系感染的普通型手足口患儿为对照组(30例).电化学发光法检测各组患儿NSE、S100β蛋白水平,ELISA检测血清和脑脊液SVCAM-1的含量,采用放射免疫分析法测定NPY的含量.结果 与对照组相比,重症手足口病患儿脑脊液和血清中NSE、S100β蛋白、sVCAM-1和神经肽Y水平显著增高(P<0.05);与重型HFMD组相比,危重型HFMD组患儿血清和脑脊液中NSE、S100β蛋白、sVCAM-1和神经肽Y水平明显增高,差异有统计学意义(P<0.05).结论 重症手足口病患儿脑脊液和血清中NSE、S100β蛋白、sVCAM-1和神经肽Y水平的变化与病情轻重有关,可用于反映脑损害的程度,还可评估其预后,对患儿损伤程度小,值得临床推广.