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目的探讨手足口病(HFMD)患儿血清中白蛋白(ALB)、前白蛋白(PA)、高敏C反应蛋白(hs-CRP)、免疫球蛋白(Ig)的水平及其临床意义。方法选择73例经确诊的HFMD患儿按是否有并发心肌损伤和或肺部感染分为有并发症组23例、无并发症组50例,同期选取36例健康对照儿童为健康对照组,检测各组儿童血清中的ALB、PA、hs-CRP、Ig水平,并比较上述指标在各组间的差异。结果两组手足口病患儿的ALB、PA、IgG、IgA、IgM均比健康对照组下降,有合并症组的PA、IgG、IgA明显下降,差异有统计学意义(P<0.01);有合并症组患儿hs-CRP水平明显升高,较其他两组差异均有统计学意义(P<0.01),但无合并症组和健康对照组比较差异无统计学意义(P>0.05);两组手足口病患儿hs-CRP检测异常率均比健康对照组增高,差异有统计学意义(P<0.05,P<0.01)。结论手足口病患儿前白蛋白下降、免疫球蛋白水平下降、hs-CRP水平升高,提示HFMD患儿存在营养状况不均衡和体液免疫功能降低,这可能是HFMD的易感因素之一,HFMD患儿检测PA、hs-CRP、Ig水平对临床治疗用药、疗效观察、病情监测和预后评估有重要的临床价值。
Objective To investigate the serum levels of albumin (ALB), prealbumin (PA), high sensitivity C reactive protein (hs-CRP) and immunoglobulin (Ig) in children with HFMD and their clinical significance. Methods Totally 73 children with HFMD who were diagnosed were divided into two groups: complication group (23 cases) and non-complication group (50 cases). In the same period, 36 healthy children were selected as healthy control group The levels of ALB, PA, hs-CRP and Ig in serum of children in each group were compared, and the differences among the above groups were compared. Results The ALB, PA, IgG, IgA and IgM in the HFMD children in both groups were significantly lower than those in the healthy control group (P <0.01). There were significant differences in PA, IgG and IgA between the two groups The level of hs-CRP in children with comorbidity was significantly higher than that in other two groups (P <0.01), but there was no significant difference between the two groups (P> 0.05). The abnormal rate of hs-CRP in children with HFMD in both groups was higher than that in healthy control group, the difference was statistically significant (P <0.05, P <0.01). Conclusions In children with HFMD, pre-albumin levels, immunoglobulin levels and hs-CRP levels are elevated in children with HFMD, suggesting that there is imbalance of nutritional status and humoral immunity in HFMD children, which may be one of the predisposing factors for HFMD. The detection of PA, hs-CRP and Ig levels in children with HFMD has important clinical value in the clinical treatment, observation of the curative effect, condition monitoring and prognosis evaluation.