EV71感染手足口病患儿去甲肾上腺素、IL-6变化趋势及作用

徐梅先; 刘刚; 曹利静; 耿文锦; 孙慧; 郭艳梅

doi:10.13898/j.cnki.issn.1000-2200.2019.09.021

EV71感染手足口病患儿去甲肾上腺素、IL-6变化趋势及作用

Change and effect of norepinephrine and interleukin-6 in HFMD children infected by EV71

摘要

摘要:
目的观察肠道病毒71（EV71）感染手足口病患儿Ⅱ、Ⅲ、Ⅳ期去甲肾上腺素（NE）、白细胞介素6（IL-6）的变化趋势，探讨其表达与病情进展的相关性。
方法比较健康儿童与EV-71感染手足口病患儿Ⅱ、Ⅲ、Ⅳ期的临床表现及实验室检查差异，检测不同阶段血液中NE、IL-6的浓度并分析二者与病情演进相关性。
结果随着HFMD进展，EV71感染患儿的临床症状包括高热持续72 h、精神差、呕吐、易激惹、呼吸困难、心率增快、毛细血管再充盈时间>2 s、白细胞计数>15×10⁹/L、葡萄糖>8.3 mmol/L出现的比例逐渐增加（P < 0.05~P < 0.01）。NE和IL-6在EV71感染HFMD患儿Ⅱ、Ⅲ、Ⅳ期的血浓度水平均明显高于对照组（P < 0.01），且随着EV-71感染分期递增其水平逐渐升高（P < 0.01）。Pearson相关分析显示，EV71感染HFMD患儿IL-6与NE的血浓度变化水平呈正相关关系（r=0.413，P < 0.05）。
结论手足口病患儿NE、IL-6水平随EV-71感染分期递增并行升高可能是EV-71感染后病情进展的重要因素，提示临床医生可能通过分析NE、IL-6水平评估患儿病情。

Abstract:
ObjectiveTo observe the levels of norepinephrine(NE) and interleukin-6(IL-6) during the stage Ⅱ, Ⅲ and Ⅳ hand foot mouth disease(HFMD) children infected by enterovirus 71(EV71), and investigate the correlation of levels of NE and IL-6 with EV71 infection.
MethodsThe differences of the clinical presentation and laboratory examination among stage Ⅱ, Ⅲ and Ⅳ HFMD children infected by EV71 and healthy children were compared.The levels of NE and IL-6 in different period were detected, and the correlation of levels of NE and IL-6 with disease progression were analyzed.
ResultsWith the progression of HFMD, the proportions of EV71 infection children with duration 72 h of high fever, poor spirit, vomiting, irritability, dysphasia, rapid heart rate, capillary refill time >2 s, white blood cell >15×10⁹/L and glucose >8.3 mmol/L gradually increased(P < 0.05 to P < 0.01).The levels of NE and IL-6 in EV71 infection stage Ⅱ, Ⅲ and Ⅳ children were significantly higher than those in healthy children, and which gradually increased with the increasing of EV71 infection staging(P < 0.01).The results of Pearson correlation analysis showed that the level of IL-6 was positively correlated with NE level in EV71 infection children(P < 0.01).
ConclusionsThe levels of NE and IL-6 in HFMD increasing with the progression of EV71 infection staging may be an important factor for the disease progression after EV71 infection, which hints that clinicians can evaluate the children's condition by analyzing the levels of NE and IL-6.

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