CAJ | 학술논문

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（P<0.001）。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（P<0.001）。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，P<0.001）。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（P<0.001）。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。
목적：탐토혈청S-100β단백결합두로핵자시부대중증수족구병구유조기식별、판단예후적림상의의。방법：수집2013년5월-2014년5월공주시부녀인동의원수족구병병구학진위수족구병적병례，기중중증수족구병조25례，보통수족구병조25례，무신경계통감염적비수족구병조20례。측정보통수족구병조、중증수족구병조급성기급회복기혈청S-100β단백함량급음성대조조급성기혈청S-100β단백함량，보통수족구병조、중증수족구병조균진행두로핵자공진검사。결과：중증수족구병조급성기S-100β단백고우음성대조조，차이유통계학의의（P<0.001）。중증수족구병조급성기급회복기S-100β단백균고우보통수족구병조，차이균유통계학의의（P<0.001）。발생두로핵자공진검출이상，중증수족구환자조위72.0%명현고우보통수족구병조적16.0%，량조비교차이유통계학의의（자2=15.909，P<0.001）。중증수족구환자조발생후유증위24.0%，보통수족구병조무후유증발생，량조비교차이유통계학의의（자2=4.735，P=0.030）。두로핵자공진검사이상조적환인급성기급회복기S-100β단백고우두로핵자공진무이상병례조，량조비교차이균유통계학의의（P<0.001）。두로핵자공진검사이상조발생후유증위27.3%，두로핵자공진무이상조무후유증발생，량조비교차이유통계학의의（P=0.012）。결론：감측수족구병환인S-100β단백가용우조기판단환인시부합병중추신경감염，가조기객관식별시부발전위중증수족구병，혈청S-100β단백결합두로핵자공진검사가평고수족구병환인뇌손상정도급판단예후。
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 severe HFMD group was higher than that of the negative control group,the difference was statistically significant(P<0.001).The S-100β protein both in acute and recovery stage of severe HFMD group were higher than those of common HFMD group, the differences were statistically significant(P<0.001).The occurrence of abnormal cranial magnetic resonance in severe HFMD group was 72.0%,which was higher than 16.0% of common HFMD group,the difference was statistically significant ( χ2=15.909,P<0.001). The occurrence of sequela in severe HFMD group was 24.0%,which was higher than that of common HFMD group,the difference was statistically significant(χ2=4.735,P=0.030).The acute and recovery phase of S-100βprotein in cranial magnetic resonance abnormalities group were significantly higher than those of cranial magnetic resonance normalities group, the differences were statistically significant(P<0.001).The occurrence of sequelae in abnormal cranial magnetic resonance examination group was 27.3%,which was higher than that of normal cranial magnetic resonance group, the difference was statistically significant(P=0.012).Conclusion:The levels of S-100β protein can be used to early judge whether the HFMD combined with central nervous system infection and early identification whether the HFMD developed to severe cases.The serum levels of S-100β protein combined with cranial magnetic resonance test can evaluate the degree of brain damage and the prognosis of HFMD.