| ObjectiveSerum NT-proBNP,CK-MB,cTnI levers and LVEF were determined in chidren with acute hand-foot-mouth disease.The aim of the study is to discuss the disease severity,early identification,the prognostic value of NT-proBNP in the children with severe HFMD.MethodThe study takes the patients with severe HFMD hospitalized in PICU and normal HFMD in fever clinic the same period as research subject at Chenzhou Children's Hospital during Match 2017 to November 2018.According to the severity of the disease,they were divided into normal group,heavy group and critical group;According to the score of pediatric critical cases within 24 hours after admission,they were divided into non-risk reorganization,dangerous reorganization,and extremely dangerous reorganization;According to whether they survived on the 7th day of hospitalization,they were divided into survival group and death group.NT-proBNP,CK-MB,cTnI and echocardiographic LVEF were performed at the initial diagnosis of the general group,within 24 hours of admission,and on the 7th day for the heavy group and critical group.NT-proBNP,CK-MB,cTnI and LVEF were compared within 24 hours of admission to different severity,death group and survival groups.NT-proBNP,CK-MB,cTnI,and LVEF were compared between the 7th day of treatment in the survival group and the 24 hours after admission;Correlation analysis was performed between NT-proBNP,CK-MB,cTnI and LVEF within 24 hours after admission to the general,heavy and critical groups.Result1.Comparison of NT-proBNP,CK-MB,cTnI and LVEF within 24 hours of admission to normal,heavy and critical groups The differences of NT-proBNP,CK-MB and cTnI between the three groups were statistically significant(P<0.01),comparison between the two groups: the critical group was higher than the heavy and normal group,and the heavy group was higher than the normal group,the difference was statistically significant(P<0.05);There was a statistically significant difference in LVEF between the three groups(P<0.01),comparison between the two groups: the critical group was significantly lower than the heavy group and the normal group,the difference was statistically significant(P<0.05),There was no significant difference between the heavy group and the normal group(P > 0.05).2.Comparison of NT-proBNP,CK-MB,cTnI and LVEF within 24 hours of admission to different PCIS score groups Comparison of NT-proBNP,CK-MB,cTnI,and LVEF levels among the three groups,the differences were statistically significant(P<0.01).Two-to-two comparison: extremely dangerous recombinant NT-proBNP,CKMB,cTnI was higher than dangerous recombination,non-risk recombination,and dangerous recombination was higher than non-risk recombination,the difference was statistically significant(P<0.01);The extremely dangerous recombinant LVEF was lower than dangerous reconstitution and non-risk recombination,and dangerous recombination was lower than that of non-risk recombination.The difference was statistically significant(P<0.01).3.Correlation analysis of NT-proBNP,CK-MB,cTnI and LVEF within 24 hours after admission NT-proBNP was positively correlated with CK-MB and cTnI(R=0.675,P=0.000,R=0.623,P=0.000),and negatively correlated with LVEF(R=-0.597,P=0.000);There was no correlation between cTnI,CK-MB and LVEF(R =-0.197,P = 0.154,R =-0.247,P = 0.103).4.The NT-proBNP,CKMB and cTnI were significantly higher in the death group than in the survival group within 24 hours after admission.The LVEF was significantly lower than that in the survival group,the difference was statistically significant(P<0.01).5.The levels of NT-proBNP,CKMB and cTnI in the 7th day of treatment group were significantly lower than those in the hospital within 24 hours after treatment.The LVEF was higher than that within the hospital within 24 hours.The difference was statistically significant(p<0.01).6.Pathogen detection results Among the 85 children with hand,foot and mouth disease,64 cases were detected with virus type,and 21 cases were not detected.The highest detection rate of virus was EV-A7129 cases(45.31%).The cases of HFMD were detected in different severity cases.The difference in pathogen composition was statistically significant(P < 0.05).The general group was mainly CV-A16 in 9 cases(50.00%);the heavy group was mainly EV-A71 in 15 cases(48.39%);the critical group was mainly EV-A71 in 11 cases(73.33%).All cases of death were EV-A71.Conclusion1.The increase of NT-proBNP and the decrease of LVEF are closely related to the severity and prognosis of the disease.The level of NT-proBNP is positively correlated with the levels of CM-KB and cTnI and negatively correlated with LVEF.2.Combined detection of NT-proBNP,CM-KB,cTnI levels and LVEF indicators,have important clinical significance for severe HFMD children with early diagnosis and recognition,the severity of the disease and prognosis. |
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