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| 重症手足口病患儿血清ACTB、SAA表达变化及临床意义 |
| Changes and clinical significance of serum ACTB and SAA expressions in children with severe hand, foot and mouth disease |
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| DOI：10.3969/j.issn.1007-8134.2021.04.011 |
| 中文关键词: 手足口病 血清 人β-肌动蛋白 血清淀粉样蛋白A |
| 英文关键词: hand, foot and mouth disease serum human β-actin serum amyloid A |
| 基金项目:陕西省课题基金项目（Z2018LSXB009） |
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| 中文摘要: |
| 目的 检测重症手足口病（hand, foot and mouth disease, HFMD）患儿血清人β-肌动蛋白（β-actin, ACTB）、血清淀粉样蛋白A（serum amyloid A, SAA）表达变化，并探讨其临床意义。方法 选取2019年2月—2020年2月在我院接受治疗的42例重症HFMD患儿作为试验组；选取同期体检的42例健康儿童作为对照组。收集研究对象的临床资料；ELISA法检测研究对象血清中ACTB、SAA表达水平；Pearson法分析重症HFMD患儿血清中ACTB、SAA表达的相关性；二元Logistic回归分析重症HFMD患儿的影响因素；ROC曲线分析血清中ACTB、SAA表达水平对重症HFMD的诊断效能。结果 与对照组相比，试验组LDH、AST、CK、CK-MB、BUN、尿视黄醇结合蛋白水平均升高（P均＜0.05），并出现发热、皮疹症状，部分患儿出现嗜睡、惊厥、头痛、躁动症状，70%以上患儿CRP＞8 mg/L，Cox A16阳性11例（26.19%），EV 71阳性31例（73.81%）。试验组血清ACTB、SAA表达水平均升高（P均＜0.05）。Pearson分析结果显示，重症HFMD患儿血清ACTB与SAA表达水平呈正相关（r=0.565，P=0.000）。二元Logistic回归分析结果显示，血清ACTB、SAA水平偏高是重症HFMD的独立危险因素（P均＜0.05）。患儿血清ACTB、SAA联合检测诊断重症HFMD的AUC为0.862，敏感度为75.2%、特异度为91.6%。结论 重症HFMD患儿血清ACTB、SAA表达水平均显著升高，是影响重症HFMD发生的独立危险因素，且联合检测对临床诊断具有一定的参考价值。 |
| 英文摘要: |
| Objective To detect the expression changes of serum human β-actin (ACTB) and serum amyloid A (SAA) in children with severe hand, foot and mouth disease (HFMD) and to explore their clinical significance. Methods Forty-two children with severe HFMD who were treated in our hospital from February 2019 to February 2020 were selected as the experimental group. Forty-two healthy children in the same period were selected as the control group. Clinical data of the subjects were collected. The expression levels of serum ACTB and SAA in subjects were detected by enzyme-linked immunosorbent assay. Pearson method was used to analyze the correlation between the expressions of serum ACTB and SAA in subjects with severe HFMD. Binary Logistic regression analysis was used to analyze the factors affecting severe HFMD children. The diagnostic efficiency of serum ACTB and SAA levels in severe HFMD was analyzed by ROC curve. Results Compared with the control group, the levels of LDH, AST, CK, CK-MB, BUN and urinary retinol binding protein (RBP) in the experimental group were increased, and all the children in the experimental group had fever and rash symptoms, some of them had drowsiness, convulsions, headache and restlessness symptoms. More than 70% of them had CRP of more than 8 mg/L, Cox A16 was positive in 11 cases (26.19%), and EV 71 was positive in 31 cases (73.81%). The expression levels of serum ACTB and SAA in the experimental group were all increased (P＜0.05). Pearson analysis showed that there was a positive correlation between serum ACTB and SAA expression levels in severe HFMD children (r= 0.565, P=0.000). Binary Logistic regression analysis showed that high levels of serum ACTB and SAA were independent risk factors of severe HFMD (P＜0.05). The AUC of combined detection of serum ACTB and SAA in the diagnosis of severe HFMD was 0.862, the sensitivity was 75.2%, and the specificity was 91.6%. Conclusions The expression levels of ACTB and SAA in serum of severe HFMD children are significantly increased, which are independent risk factors for severe HFMD, and the combined detection can provide some reference for clinical diagnosis. |
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