手足口病患儿血中免疫球蛋白和超敏C反应蛋白联合检测的应用研究

目的探讨免疫球蛋白（Ig）和超敏C反应蛋白（hs-CRP）在小儿手足口病（HFMD）中检测的临床价值及应用研究。方法选取HFMD患儿76例（HFMD组），均采用利巴韦林治疗，根据治疗效果又分为好转组和无效组；选择同期儿童健康体检者80名（对照组）。分别检测HFMD组和对照组Ig（IgA、IgG、IgM）和hs-CRP水平，评价2个指标在HFMD的诊断与治疗疗效观察中的敏感性和特异性，并绘制ROC曲线进行相关性分析。结果观察组Ig中IgA、IgG水平均低于对照组（P < 0.01），而IgM、hs-CRP均高于对照组（P < 0.01）；观察组经利巴韦林治疗后64例好转，12例无效；好转组中IgA、IgG水平均高于无效组（P < 0.05），IgM、hs-CRP水平均低于无效组（P < 0.01）。IgA、IgG、IgM和hs-CRP在小儿HFMD中诊断敏感性、特异性差异无统计学意义（P>0.05），Ig联合hs-CRP诊断小儿HFMD敏感性、特异性，高于单一指标（P < 0.05）。结论Ig和hs-CRP联合检测对于HFMD患儿早期诊断具有辅助筛查作用，且对于已明确患儿疾病严重程度、疾病的进展和指导临床治疗具有较高的临床价值，值得推广应用。

The application value of the joint detection of Ig and hs-crp in children with hand,foot and mouth disease

ObjectiveTo investigate the clinical value and application research of immunoglobulin(Ig) and hypersensitive C reactive protein(hs-CRP) in children with hand, foot and mouth disease(HFMD).MethodsSeventy-six children with HFMD(HFMD group) were treated with ribavirin, and subdivdied into the improvement group and invalid group according to the therapeutic effects.Eighty health physical examination children were set as the control group.The levels of Ig(IgA, IgG and IgM) and hs-CRP in HFMD group and control group were detected.The sensitivity and specificity of two indexes in the diagnosis and treatment of HFMD were evaluated, and the ROC curve was plotted for correlation analysis.ResultsThe levels of IgA and IgG in HFMD group were lower than those in control group(P < 0.01).The levels of IgM and hs-CRP in HFMD group were higher than those in control group(P < 0.01).After the HFMD group were treated with ribavirin, 64 cases were improved, and 12 cases were invalid.The levels of IgA and IgG in improvement group were higher than those in invalid group(P < 0.05), and the levels of IgM and hs-CRP in improvement group were lower than those in invalid group(P < 0.01).The differences of the sensitivity and specificity of IgA, IgG, IgM and hs-CRP in the diagnosis of HFMD children were not statistically significant(P>0.05).The sensitivity and specificity of Ig combined with hs-CRP in the diagnosis of HFMD children were higher than those of single indicator(P < 0.05).ConclusionsThe joint detection of Ig and hs-CRP plays auxiliary screening function in the early diagnosis of HFDH, can identify the severity and development and guide the clinical treatment, and has high clinic value.It is worthy of promoting.