沙敏

[摘要] 目的 探究柯薩奇病毒16型（CA16）、肠道病毒71型（EV71）两种病毒，以及白细胞计数（WBC）、谷丙转氨酶（ALT）及谷草转氨酶（AST）、肌酸激酶同工酶（CKMB）四种检验指标对小儿手足口病的影响和诊断效果。方法 便利择取2018年1月—2019年7月在该院进行治疗的疑似手足口病患儿共560例，2018年1—12月入院患儿设置为对照组，2019年1—7月入院患儿设置为观察组，每组280例。通过胶体金法判定EV71性质，按照不同性质排列组合分为4组，比较4组WBC、ALT、AST及CKMB检查结果。结果 对照组280例患儿中CA16患儿共35例，阳性率12.50%，观察组280例患儿中CA16阳性患儿共30例，阳性率10.71%，差异无统计学意义（χ2=0.435，P>0.05）。定性检验结果显示CA16阳性和EV71阳性组患儿63例，CA16阳性及EV71阴性组患儿58例，CA16阴性和EV71阳性组患儿502例，CA16阴性和EV71阴性组495例，CA16阳性和EV71阳性和CA16阳性及EV71阴性患儿WBC、ALT、AST及CKMB检查结果差异无统计学意义（P>0.05），CA16阳性和EV71阳性、CA16阴性及EV71阳性患儿CKMB显著高于另外两组，差异有统计学意义（P<0.05）。结论 疑似CA16手足口病患儿开展WBC、ALT、AST及CKMB等血液指标检查对疾病确诊无理想效果，因此不建议在临床中推广应用，而CKMB检查可作为EV71阳性患儿的确诊。

[关键词] CA16;EV71;WBC;ALT;AST;CKMB

[中图分类号] R927.1          [文献标识码] A          [文章编号] 1674-0742（2020）03（a）-0186-03

Effect of CA16， EV71 and WBC， ALT， AST and CKMB Tests on the Diagnosis of Hand， Foot and Mouth Disease in Children

SHA Min

Department of Laboratory Medicine， Guanxian People's Hospital， Guanxian， Shandong Province， 252500 China

[Abstract] Objective To investigate two types of Coxsackievirus 16 （CA16） and enterovirus 71 （EV71）， as well as white blood cell count （WBC）， alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， and creatine kinase isoenzyme （CKMB）， the effects of four test indexes on the diagnosis of hand， foot and mouth disease in children. Methods A total of 560 children with suspected hand， foot and mouth disease who were treated in the hospital from January 2018 to July 2019 were convenient selected. The children admitted from January to December 2018 were set as the control group， and from January to July 2019 of children were set up as observation group with 280 cases in each group. The colloidal gold method was used to determine the properties of EV71， and they were divided into 4 groups according to different properties. The results of WBC， ALT， AST and CKMB were compared. Results Among the 280 children in the control group， there were 35 of CA16 children with a positive rate of 12.50%. Among the 280 children in the observation group， there were 30 of CA16 positive children with a positive rate of 10.71%. The difference was not statistically significant （χ2=0.435， P>0.05）. Qualitative results showed 63 children in the CA16 positive and EV71 positive groups， 58 children in the CA16 positive and EV71 negative groups， 502 children in the CA16 negative and EV71 positive groups， 495 patients in the CA16 negative and EV71 negative groups， CA16 positive and EV71 The results of WBC， ALT， AST， and CKMB in children with positive and CA16 positive and EV71 negative were not statistically significant （P>0.05）. The children with CA16 positive and EV71 positive， CA16 negative and EV71 positive had significantly higher CKMB than the other two groups. The difference was statistically significant （P<0.05）. Conclusion Testing of blood indicators such as WBC， ALT， AST， and CKMB in children with suspected CA16 hand-foot-mouth disease has no ideal effect on the diagnosis of the disease， so it is not recommended to promote its application in the clinic.

[Key words] CA16; EV71; WBC; ALT; AST; CKMB

手足口病是临床常见儿科传染病之一，其病因为肠道病毒感染所致，以5岁以下儿童为主要发病群体。该疾病病毒最后宿主是患儿本身，可通过呼吸道、消化道和直接接触等途径进行传播，对患儿的健康造成了严重的威胁，严重者具有死亡风险，因此明确患儿感染类型，对症下药对控制患儿病情和促进其康复具有重要意义[1-2]。诱发该疾病的主要病毒包括柯萨奇病毒16型（CA16）、肠道病毒71型（EV71）两种，为探究白细胞计数（WBC）、谷丙转氨酶（ALT）及谷草转氨酶（AST）、肌酸激酶同工酶（CKMB）等常见血液指标检查对该疾病的诊断效果[3]。该次研究……