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目的探讨深圳市儿童血清中微量元素硒(Se)水平与手足口病感染的相关性。方法于2013-2015年间在深圳市儿童医院采集手足口病病例422例和健康儿童208例的咽拭子/肛拭子样本及血样。采用实时荧光定量PCR检测咽拭子/肛拭子病原体类型。用电感耦合等离子质谱法(ICP-MS)分析血清中Se含量。结果病例组血清Se水平低于对照组(P<0.001),而在重症与轻症间差异无统计学意义(P=0.371);重症、轻症和健康组血清Se水平在性别间差异均无统计学意义(P>0.05);在重症和轻症组中,≤3岁患儿血清Se水平均低于>3岁组患儿(P<0.05),而健康儿童年龄组间差异无统计学意义(P=0.207);血清Se水平在EV71、CA16与其他病毒感染组间差异无统计学意义(P=0.985);Spearman秩相关分析结果显示病情与血清Se水平负相关(P<0.001),同时Logistic回归结果显示高Se水平是手足口病患儿的保护因素(OR值<1,P<0.05)。结论儿童手足口病感染与微量元素Se有关,加强儿童血清Se水平监测与评估,做到及时补充,对增强免疫力和改善病情具有一定的意义。
Objective To investigate the correlation between serum Se (Se) in children and hand-foot-mouth disease in children in Shenzhen. Methods A total of 422 cases of hand-foot-mouth disease and 208 children with throat swabs / anus swabs and blood samples were collected from Shenzhen Children’s Hospital from 2013 to 2015. Real-time fluorescence quantitative PCR was used to detect the type of throat swab / rectal swab pathogens. Se content was analyzed by inductively coupled plasma mass spectrometry (ICP-MS). Results Serum Se levels were lower in the case group than those in the control group (P <0.001), but there was no significant difference between severe and mild cases (P = 0.371). There was no significant difference in Se levels between the severe, mild and healthy groups (P> 0.05). In severe and mild cases, serum Se level in children ≤3 years old was lower than that in children> 3 years old (P <0.05), but there was no significant difference between healthy children in age group (P = 0.207). There was no significant difference in serum Se levels between EV71, CA16 and other virus infection groups (P = 0.985). Spearman rank correlation analysis showed that the serum Se levels were negatively correlated with serum Se levels (P <0.001) At the same time Logistic regression analysis showed that the high Se level was the protective factor in HFMD (OR <1, P <0.05). Conclusion Hand-foot-mouth disease in children is associated with trace element Se. It is of great significance to strengthen the monitoring and evaluation of selenium level in children so that they can be replenished promptly to enhance immunity and improve the disease.