论文部分内容阅读
目的探讨检测外周静脉血白细胞介素-6(IL-6)及血糖水平对手足口病(HFMD)患儿病情变化及预后判断的价值。方法选取2011年1月至2013年12月于杭州市儿童医院住院治疗的HFMD患儿513例纳入研究,并根据病情的严重程度分为轻症组、重症组及危重症组。分别于入院后1、24、48、72h及病情变化时,检测外周静脉血IL-6水平。并在住院过程中对血糖进行动态监测。采用SPSS 19.0进行统计分析,计量资料进行单因素方差分析或t检验,计数资料进行χ2检验或Fisher确切概率法,P<0.05为差异有统计学意义。结果在IL-6峰值水平方面,轻症组在入院24h时达高峰,重症组在48h时达高峰,而危重症组在入院72h仍呈持续上升水平。危重症组入院后1、24、48、72h外周静脉血IL-6水平在各个时间点均高于重症组和轻症组,差异有统计学意义(F=312.32、320.35、332.13、622.77,均P<0.01),而重症组IL-6水平在各个时间点亦高于轻症组,差异有统计学意义(t=43.82、46.43、50.72、47.22,P<0.01)。入院时,重症组、危重症组的空腹血糖值(F=10.534,P<0.01)和血糖升高比例(χ2=299.772,P<0.01)均高于轻症组,差异有统计学意义。住院过程中,重症组、危重症组患者的入院1d随机血糖最高值(F=12.183,P<0.01)和血糖升高比例(χ2=258.363,P<0.01)与轻症组比较差异均有统计学意义。血糖升高组患儿平均住院日长于血糖正常组,差异有统计学意义(t=22.762,P<0.01);治愈率低于血糖正常组,差异有统计学意义(χ2=78.499,P<0.01);后遗症发生率高于血糖正常组,差异有统计学意义(χ2=6.414,P<0.05)。结论动态监测外周静脉血IL-6、血糖水平的变化,有助于判断HFMD患者的病情变化及评估预后,对早期血糖及IL-6升高者应严密观察,利于早期发现危重病例并加以干预,阻止病情进一步恶化。
Objective To investigate the value of peripheral venous blood IL-6 and blood glucose levels in the diagnosis and prognosis of HFMD in children. Methods A total of 513 HFMD children hospitalized in Hangzhou Children’s Hospital from January 2011 to December 2013 were included in the study. According to the severity of the disease, the patients were divided into mild group, severe group and critically ill group. Peripheral venous blood IL-6 levels were measured at 1, 24, 48 and 72 h after admission and when the condition changed. And in the hospital during the dynamic monitoring of blood glucose. SPSS 19.0 was used for statistical analysis, measurement data were analyzed by one-way ANOVA or t test, count data for χ2 test or Fisher exact test, P <0.05 for the difference was statistically significant. Results In the peak level of IL-6, the mild group reached its peak at 24 hours of admission, the peak of severe group reached peak at 48 hours, while the critical illness group continued to rise at 72 hours after admission. The levels of IL-6 in peripheral venous blood of critically ill patients at 1,24,48,72h after admission were significantly higher than those in severe and mild cases at all time points (F = 312.32, 320.35, 332.13, 622.77, P <0.01). The levels of IL-6 in severe group were also higher than those in mild group at each time point (t = 43.82,46.43,50.72,47.22, P <0.01). At admission, the fasting blood glucose (F = 10.534, P <0.01) and the elevated blood glucose (χ2 = 299.772, P <0.01) were significantly higher in the critically ill patients and the critically ill patients than in the mild patients. The difference was statistically significant. During hospitalization, the difference between the severe group and critically ill group was statistically significant (P <0.01), the highest level of random blood glucose (F = 12.183, P <0.01) Significance of learning. The average length of hospital stay in patients with hyperglycemia was longer than that in patients with normal glucose (t = 22.762, P <0.01), and the cure rate was lower than that in patients with normal glucose (χ2 = 78.499, P <0.01) ); The incidence of sequelae was higher than that of normal blood glucose group, the difference was statistically significant (χ2 = 6.414, P <0.05). Conclusion Dynamic monitoring of peripheral venous blood IL-6, blood glucose levels changes, help determine the HFMD patients with disease progression and prognosis, early blood glucose and elevated IL-6 should be closely observed, which will help early detection and intervention of critically ill patients , To prevent further deterioration of the condition.