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目的探讨血糖、白细胞计数及血浆C反应蛋白(hs-CRP)测定对手足口病患儿病情和预后判断的价值。方法 432例手足口病患儿(治疗组),其中包含普通型234例,发热重型198例。于入院时和治疗3d、7d后分别检测空腹血糖、全血白细胞计数和hs-CRP水平,并与322例健康体检者(对照组)比较。结果入院时观察组血糖、白细胞计数、hs-CRP水平均明显高于对照组(P均<0.05),hs-CRP阳性率明显高于血糖阳性率及白细胞数阳性率(P<0.05);其中重型患儿空腹血糖水平显著高于对照组(P<0.05),而普通型与对照组比较无显著差异。治疗3d后观察组hs-CRP、白细胞计数水平均明显下降;其中重型患儿明显降低(P<0.05)。治疗7d后观察组血糖、白细胞计数水平均明显下降;其中重型患儿明显降低(P<0.01)。Pearson相关分析示病情严重程度与空腹血糖和白细胞计数水平均呈正相关,与hs-CRP水平无明显相关性。结论 hs-CRP可作为手足口病早期诊断和指导临床用药的敏感指标,而血糖和白细胞计数可作为判断病情和预后的主要参考指标。
Objective To investigate the value of blood glucose, white blood cell count and plasma C-reactive protein (hs-CRP) determination in children with hand-foot-mouth disease and prognosis. Methods 432 cases of hand-foot-mouth disease patients (treatment group), including 234 cases of common type, severe 198 cases of fever. Fasting blood glucose, whole blood white blood cell count and hs-CRP levels were measured at admission and after 3 and 7 days of treatment, respectively, and compared with 322 healthy controls (control group). Results The blood glucose, white blood cell count and hs-CRP levels in the observation group were significantly higher than those in the control group on admission (P <0.05), and the positive rate of hs-CRP was significantly higher than that of the positive rate of blood glucose and white blood cell count (P <0.05) The level of fasting blood glucose in children with severe type was significantly higher than that in the control group (P <0.05), but there was no significant difference between the common type and the control group. The levels of hs-CRP and leucocyte in observation group decreased significantly after treatment for 3d, especially in severe type (P <0.05). After 7 days of treatment, the levels of blood glucose and white blood cell count in the observation group decreased significantly, especially in severe type (P <0.01). Pearson correlation analysis showed that the severity of the disease was positively correlated with the level of fasting blood glucose and white blood cell count, but not with the level of hs-CRP. Conclusion hs-CRP can be used as a sensitive indicator of early diagnosis and guidance of clinical medication for hand-foot-mouth disease, and blood glucose and white blood cell count can be used as the main reference indicators to judge the disease and prognosis.