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目的:分析重症手足口病合并脑炎患儿血清血管细胞粘附因子-1(VCAM-1)、血管内皮生长因子(VEGF)水平及其临床意义。方法:以2013年1月至2016年5月我院诊治的手足口病患儿90例为研究对象,根据是否合并脑炎将其分为观察组(合并脑炎)45例、对照组(未合并脑炎)45例。观察组中重型22例,危重型23例。统计分析患儿脑脊液常规分析指标(脑脊液蛋白质、脑脊液白细胞计数)水平及脑脊液和血清中VCAM-1、VEGF水平。结果:观察组患儿入院时脑脊液中蛋白质、白细胞计数水平,脑脊液和血清中VCAM-1、VEGF水平均显著高于对照组(P<0.05),观察组中,危重症患儿的脑脊液白细胞计数和脑脊液中VCAM-1水平显著高于重症患儿,差异有统计学意义(P<0.05),危重症患儿的脑脊液蛋白质、血清VCAM-1、VEGF水平、脑脊液VEGF均高于对照组,但差异无统计学意义(P>0.05)。患儿血清VCAM-1水平与脑脊液蛋白质、白细胞计数和VCAM-1水平均呈显著正相关(相关系数r=0.852,0.791,0.775,P<0.05),患儿血清VEGF水平与脑脊液蛋白质、白细胞计数和VEGF水平均呈显著正相关(相关系数r=0.809,0.882,0.813,P<0.05)。结论:重症手足口病合并脑炎患儿血清和脑脊液中VCAM-1、VEGF水平显著上调,且均与脑脊液蛋白质、白细胞计数和VEGF水平显著相关,对于重症手足口病合并脑炎的辅助诊断具有重要的临床意义。
Objective: To analyze the levels of serum vascular cell adhesion molecule-1 (VCAM-1) and vascular endothelial growth factor (VEGF) in children with severe hand-foot-and-mouth disease complicated with encephalitis and its clinical significance. Methods: From January 2013 to May 2016, 90 children with hand-foot-mouth disease diagnosed and treated in our hospital were divided into observation group (encephalitis-merger group) and control group Merger encephalitis) 45 cases. The observation group of 22 cases of heavy and 23 cases of critical type. Statistical analysis of routine cerebrospinal fluid analysis of children with cerebrospinal fluid (cerebrospinal fluid protein, CSF white blood cell count) levels and cerebrospinal fluid and serum VCAM-1, VEGF levels. Results: The levels of protein and leukocyte in cerebrospinal fluid (CSF), the levels of VCAM-1 and VEGF in CSF and serum of children in observation group were significantly higher than those in control group (P <0.05) (P <0.05). The levels of CSF protein, serum VCAM-1, VEGF and cerebrospinal fluid VEGF in critically ill children were higher than those in control group, but the level of VCAM-1 in cerebrospinal fluid was significantly higher than that in severe cases The difference was not statistically significant (P> 0.05). Serum levels of VCAM-1 in children with cerebrospinal fluid protein and white blood cell count and VCAM-1 levels were positively correlated (r = 0.852,0.791,0.775, P <0.05), serum VEGF levels in children with cerebrospinal fluid protein, white blood cell count And VEGF levels were significantly positive correlation (correlation coefficient r = 0.809,0.882,0.813, P <0.05). Conclusions: The levels of VCAM-1 and VEGF in serum and cerebrospinal fluid of children with severe HFMD complicated by encephalitis were significantly up-regulated, and both of them were significantly associated with CSF protein, leukocyte counts and VEGF levels. The diagnosis of severe HFMD complicated with encephalitis had Important clinical significance.