EV71感染手足口病患儿血清儿茶酚胺水平测定及临床应用

目的：探讨EV71感染手足口病患儿血清儿茶酚胺水平的变化及意义。方法：采用高效液相色谱一电化学法测定70例Ev71感染手足口病患儿（其中普通型50例，重症型20例）和10例健康儿童（对照组）的血清去甲肾上腺素（NE）、肾上腺素（E）和多巴胺（DA）水平，并分析其与血糖和白细胞计数等指标的相关性。结果：Ev71感染手足口病患儿血清NE、E、DA水平均显著高于对照组（P〈0．05），重症Ev71感染组的血清NE水平显著高于普通Ev71感染组（P〈0．05），但两组间血清E和DA水平无明显差别（P〉0．05）。重症EV71感染组的血糖和白细胞水平、头颅和上颈髓病变发生率均显著高于普通EV71感染组（P〈0．05）。重症EV71感染患儿的血清NE水平与血糖、白细胞计数及头颅和上颈髓MRI病变之间均呈正相关，而血清E和DA水平与上述指标均无明显相关性（P〉0．05）。结论：EV71感染手足口病患儿血清儿茶酚胺水平显著增加，其中去甲肾上腺素水平可作为重症病例的早期识别指标。

Serum catecholamine levels determination in children with hand-foot-mouth disease by EV71 infection and clinical application

Objective ： To investigate the levels and clinical significance of serum catecholamine in children with hand-foot-mouth disease （HFMD） by EV7I infection. Methods ： Serum norepinephrine, epinephrine and dopamine were measured by HPLC-ECD in 70 children with HFMD by EV71 infection and 20 healthy children. The relationship between serum catecholamine and blood glucose and white blood cells （WBC） were analyzed respectively.Results ： Serum norepinephrine, epinephrine and dopamine levels of children with HFMD by EV71 infection were significantly higher than those in the control group （P〈O.05）. The norepinephrine levels were significant difference between subgroups of HFMD （P〈O.05）, but there was no significant difference of epinephrine and dopamine between the subgroups （P〉0.05）. Blood glucose, WBC count and pathological changes of skull and upper cervical cord of severe EV71 infection group were significantly higher than those in ordinary EV71 infection group （P〈O.05）. There were significantly positive correlations between serum norepinephrine, blood glucose, WBC count and pathological changes of skull and upper cervical cord in severe EV71 infection group （P〈0.05）, while no relationship between serum epinephrine and dopamine and these index （P〉0.05）.Conclusions ： The levels serum catecholamine are significant increased in children with HFMD by EV71 infection, norepinephrine is a good indicators of the early diagnosis in severe EV71 infection children.