本文選題：手足口病 + 腦炎�。� 參考：《福建醫(yī)科大學》2014年碩士論文

【摘要】：目的探討手足口病(Hand-foot-mouth Disease,HFMD)患兒血清神經元特異性烯醇化酶(neuron-specific enolase,NSE)及Sangtec-100β(S-100β)蛋白和腦損傷的關系。方法連續(xù)入院2014年3月至2014年8月在泉州兒童醫(yī)院住院治療的HFMD患兒137例,按照2010年版衛(wèi)生部印發(fā)的《手足口病診療指南》的臨床診斷標準,根據(jù)臨床癥狀及體征,將患兒分危重型組(n=15)、重型組(n=68)、普通組(n=54)。設同期健康體檢兒對照組(n=20)。在病情急性期(即入院24小時內)進行腰椎穿刺檢查腦脊液細胞學和生化,抽取靜脈血采用電化學免疫發(fā)光法測定患兒NSE及S-100β蛋白,同時記錄患兒年齡、性別、顱腦MRI、血白細胞計數(shù)、血糖、谷丙轉氨酶、血肌酐等。結果1.危重型組、重型組和普通組在性別、年齡、血白細胞計數(shù)、谷丙轉氨酶、血肌酐方面無統(tǒng)計學顯著性差異(P0.05),危重型組血糖顯著高于其他三組血糖(P0.05)。2.血清NSE檢測結果:危重型組和重型組NSE顯著高于普通組和對照組NSE(P0.05),危重型組和重型組之間NSE差異有統(tǒng)計學意義(P0.05),普通組和對照組之間NSE差異無統(tǒng)計學意義(P0.05)。3.血清S-100β蛋白檢測結果:危重型組和重型組S-100β顯著高于普通組和對照組S-100β(P0.05),危重型組和重型組之間S-100β差異有統(tǒng)計學意義(P0.05),普通組和對照組之間S-100β差異無統(tǒng)計學意義(P0.05)。4.危重型患兒顱腦MRI可見不同程度腦損傷,監(jiān)測血清NSE及S-100β蛋白數(shù)值可間接評估HFMD合并腦炎及腦損傷的嚴重程度,并根據(jù)數(shù)值判斷預后情況。結論根據(jù)不同組別血清NSE及S-100β蛋白的含量檢測情況,可見危重型組NSE及S-100β濃度顯著高于重型組、普通組及對照組,提示血清NSE及S-100β蛋白的升高說明患兒存在神經系統(tǒng)的損害,并且與病情的嚴重程度呈正相關。
[Abstract]:Objective to investigate the relationship between serum neuron-specific enolase (NSE) and Sangtec-100 尾 -S-100 尾 protein and brain injury in children with Hand-foot-mouth disease (Hand-foot-mouth disease). Methods from March 2014 to August 2014, 137 patients with HFMD were hospitalized in Quanzhou Children's Hospital. According to the clinical diagnosis criteria of hand, foot and mouth disease issued by the Ministry of Health in 2010, according to the clinical symptoms and signs, 137 cases of HFMD were hospitalized in Quanzhou Children's Hospital from March 2014 to August 2014. The children were divided into critical group (n = 15), severe group (n = 68) and common group (n = 54). At the same time, the control group of healthy children was established. Cerebrospinal fluid (CSF) cytology and biochemistry were examined during the acute phase of the disease (i.e. within 24 hours of admission). The NSE and S-100 尾 protein were determined by electrochemiluminescence (ECL) in venous blood samples, and the age and sex of the patients were recorded. Craniocerebral MRI, white blood cell count, blood glucose, alanine aminotransferase, serum creatinine, etc. Result 1. There was no significant difference in sex, age, white blood cell count, glutamic-pyruvic transaminase and serum creatinine between the critical group, the severe group and the normal group (P 0.05), but the blood glucose in the critical type group was significantly higher than that in the other three groups (P 0.05). The results of serum NSE detection: NSE in critical and severe group was significantly higher than that in normal group and control group (P 0.05). There was significant difference in NSE between critical group and severe group (P 0.05). There was no significant difference in NSE between normal group and control group (P 0.05). The results of serum S-100 尾 protein detection showed that S-100 尾 was significantly higher in critical and severe group than that in normal group and control group. There was a significant difference in S-100 尾 between critical group and severe group (P 0.05), but there was no significant difference in S-100 尾 between normal group and control group (P 0.05 路4). Brain MRI showed different degrees of brain injury in critically ill children. Monitoring the values of serum NSE and S-100 尾 protein could indirectly evaluate the severity of HFMD associated with encephalitis and brain injury, and judge the prognosis according to the values. Conclusion according to the detection of serum NSE and S-100 尾 protein in different groups, it can be seen that the concentration of NSE and S-100 尾 in critical type group is significantly higher than that in severe group, common group and control group, suggesting that the increase of serum NSE and S-100 尾 protein may indicate the nervous system damage in children. There was a positive correlation between the severity of the disease and the severity of the disease.
【學位授予單位】：福建醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R725.1

【參考文獻】

相關期刊論文 前3條

1 李國良;神經元特異性烯醇化酶變化在癲癇發(fā)作中的意義[J];國外醫(yī)學.神經病學神經外科學分冊;1997年04期

2 楊思達,何馨,何旦莎,楊鎰宇,祝惠華,鄧維意;小兒全身性癲癇與髓鞘堿性蛋白關系的研究[J];小兒急救醫(yī)學;2000年03期

3 陳萍;李自如;馬翔凌;;血清NSE和S-100β蛋白在癲癇急性發(fā)作患者中的變化及臨床價值[J];內蒙古醫(yī)學雜志;2009年07期

，

本文編號：1843787