Detection Of Catecholamine In Severe Cases With EV71 Infection

Objectives In order to look for the early identification of warning indicators for children with severe enterovirus 71(EV71) infection, the alteration of catecholamine(CA) secretion in children with severe disease were analysised in hand foot and mouth disease(HFMD) with EV71 infection and the correlation between the level of CA and vital signs in severe cases were discussed.Methods Total of 83 cases with severe hand foot and mouth disease who met the criteria as the experimental group treated in Tangshan Maternity and Children Health Hospital during April 1, 2015 to September 31, 2015 were selected. According to the diagnostic criteria of "enterovirus 71(EV71) infection in severe cases clinical treatment expert consensus(2011 edition) ", the severe patients were divided into severe group and critical group. Total of 69 cases with common hand foot mouth disease of EV71 infection were used as the control group. Recording the general information of the experimental group and the control group, such as gender, age, and place of residence. At the same time completed the relevant auxiliary examination items, such as blood routine examination, creactive protein(CRP), biochemical full term, T lymphocyte subsets and so on. The respiratory, heart rate, blood pressure, oxygen saturation and peripheral circulation of the experimental group were recorded in every 2 hours. The children of experimental group and control group were detected CA when enrolled in the group(including norepinephrine, epinephrine, and dopamine). Blood CA was detected in recovery period of the heavy group of. The children in severe group were tested the level of CA at 6 hours, 12 hours, 24 hours and the recovery period after entering the group. The patients who were in heavy stage progressed to severe, treated as severe group. Then the CA was tested according to the critical group. Establishment Excel table, entering all the records and the results of the experimental data. Chooseing the correct statistical methods.Results 1 The difference of catecholamine(including norepinephrine, epinephrine, and dopamine) level among the ordinary group, severe group and critical group all had statistically significant(P<0.05). Pairwise comparison showed that the difference of norepinephrine(NE), epinephrine(E) and dopamine(DO) between the ordinary and severe, the ordinary and critical, severe and critical all had statistically significant(P<0.05). The level of NE, E, DO in severe group and critical group was higher than that of the control group. The level of NE, E, DO in critical group was higher than that of severe group. 2 The level of NE, E and DO in the recovery period of the severe group were lower than that in the acute stage, and there were significant differences(P<0.05). 3 The level of NE, E, DO in patients who were in severe progressed to critical were compared, comparing the level of NE, E, DO between the severe group and critical group when entering the group, and the difference had statistically significant(P<0.05). The critical group was significantly higher than that in severe group. 4 The level of NE, E and DO at different time in the severe group had statistically significant(P<0.05). Pairwise comparison showed that the difference of NE, E, DO in each time had statistically significant. The level of NE, E, DO when enrolling in the group, 6 hours, 12 hours, 24 hours showed an increase trend. The level of NE, E, DO in the recovery period was lower than the acute stage. 5 The correlation of NE, E, DO and heart rate, respiration, systolic blood pressure, diastolic blood pressure of severe children in acute phase were analyzed, and the results showed that heart rate and respiration were positively correlated with NE, E, and DO. 6 The correlation of NE, E, DO in different time and the corresponding heart rate, respiration, systolic blood pressure, diastolic blood pressure in critical group were analyzed. And the results showed that NE and the diastolic blood pressure, heart rate have correlation, but E, DO had no correlation with heart rate, respiration, systolic blood pressure, diastolic blood pressure. 7 The 10 indicators(NE, E, DO, respiration, heart rate, mean arterial pressure, gender, age, WBC, residence) had statistically significant between the experimental group and the control group. These 10 indicators were analyzed by binary logistic regression analysis. The results indicated that the rise of E and mean arterial pressure in the acute phase were the risk factors.Conclusions 1 The level of catecholamine(including NE, E, DO) in severe group was higher than that of ordinary children and the critical group was higher than severe. CA can be used as an early indicator of severe cases. 2 The level of catecholamine in acute stage of severe cases with EV71 infection had a positive correlation with breathing and heart rate. Monitoring of respiration and heart rate is helpful for early identification of severe. 3 The risk factors in children with EV71 infection were the rise of mean arterial pressure and E level.