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[摘要] 目的 探讨血清淀粉样蛋白A、C-反应蛋白与免疫球蛋白对手足口病患儿早期诊断的价值。 方法 选择我院2020年1—12月收治手足口病患儿50例为实验组，另选择同期接收健康体检儿童50名为对照组，均采集空腹静脉血检测两组血清淀粉样蛋白A（SAA）、C-反应蛋白（CRP）水平与免疫球蛋白（IgA、IgG、IgM）水平进行比较，并比较单独检验与联合诊断的敏感度、特异度。 结果 实验组SAA、CRP水平均高于对照组，差异有统计学意义（P<0.05）。实验组IgA、IgG低于对照组，IgM水平高于对照组，差异有统计学意义（P<0.05）。联合检验SAA、CRP、Ig诊断敏感度较两两联合检验更高，差异有统计学意义（P<0.05）。三种指标联合检验与两两联合检验的特异度比较，差异无统计学意义（P>0.05）。 结论 手足口病患儿血清淀粉样蛋白A、C反应蛋白、免疫球蛋白表达异常，通过联合检测可提高对手足口病患儿诊断的诊断效能，且检验简单快捷，值得推广。

[关键词] 手足口病;血清淀粉酶氧蛋白A;C-反应蛋白;免疫球蛋白;联合检测

[中图分类号] R446.11          [文献标识码] B          [文章编号] 1673-9701（2021）32-0143-04

[Abstract] Objective To explore the value of using serum amyloid A， C-reactive protein and immunoglobulin for the early diagnosis in children with hand-foot-mouth disease（HFMD）. Methods A total of 50 cases of children with HFMD admitted to our hospital from January to December 2020 were selected as the experimental group， and 50 cases of children receiving health check-ups at the same period were selected as the control group. Fasting venous blood was collected from both groups to test the levels of serum amyloid A （SAA） and C-reactive protein （CRP） and immunoglobulins （IgA， IgG， IgM） for comparative analysis. The sensitivity and specificity of the individual and joint detection were respectively analyzed. Results The levels of SAA and CRP in the experimental group were higher than those in the control group， and the differences were statistically significant（P<0.05）. The IgA and IgG in the experimental group were lower than those in the control group， and the IgM levels were all higher than those in the control group， and the differences were statistically significant（P<0.05）. The diagnostic sensitivity of joint detection of SAA， CRP and Ig was higher than that of the two-two joint test， and the difference was statistically significant （P<0.05）. There was no statistically significant difference between the specificity of the joint detection of the three indicators and the two-two joint detection （P>0.05）. Conclusion The joint detection can improve the diagnostic efficacy of serum amyloid A， C-reactive protein and immunoglobulin expression abnormalities in children with HFMD， and the detection method is simple and fast， so it is worth promoting.

[Key words] Hand-foot-mouth disease; Serum amyloid A; C-reactive protein; immunoglobulin; Joint detection

手足口病屬于临床常见的感染性疾病，以婴幼儿为高发群体，由病毒感染而引发，临床表现为手足口疱疹，如未得到及时治疗，存在并发神经系统疾病的风险，对患儿健康造成严重威胁。若早期诊断与治疗，则可迅速控制病情，改善患儿预后，故需要积极探讨适用于手足口病早期鉴别诊断的简便、快速的检验方法[1]。目前临床常采用血清淀粉样蛋白A（Serum amyloid A，SAA）、C-反应蛋白（C-reactive protein，CRP）进行手足口病的辅助诊断，SAA、CRP作为与炎症、感染密切相关的急性时相反应蛋白，对本病的早期鉴别与诊断有较高价值[2]。……