Objective: To study the value of serum S100B protein and neuron-specific enolase (NSE) levels in predicting the severity of hand, foot and mouth disease (HFMD).
Methods: Ninety children with HFMD were classified into three groups: common type, severe type, and critical type (n=30 each). Thirty healthy children were randomly selected as the control group. ELISA was used to measure serum levels of S100B protein and NSE before and at 7 days after treatment. The receiver operating characteristic (ROC) curve was used to evaluate the prediction efficiency of S100B protein and NSE for the severity of HFMD.
Results: The critical type group had significant increases in the serum levels of S100B protein and NSE compared with the other three groups (P<0.01). The severe type group had significant increases in serum levels of S100B protein and NSE compared with the common type and control groups (P<0.01). The critical type and severe type groups had significant reductions in serum levels of S100B protein and NSE after treatment (P<0.05). Serum S100B protein had the highest Youden value of 0.611 at the cut-off value of 0.445 μg/L, with a sensitivity of 61% and a specificity of 100%, in the prediction of serious HFMD (including severe type and critical type HFMD). Serum NSE had the highest Youden value of 0.533 at the cut-off value of 5.905 μg/L, with a sensitivity of 80% and a specificity of 73%, in the prediction of serious HFMD. Combined measurements of these two parameters had a sensitivity of 86% and a specificity of 73% and had the highest predictive value for serious HFMD.
Conclusions: The serum levels of S100B protein and NSE help to predict the severity and treatment outcomes of HFMD. Combined measurements of these two parameters has a higher predictive value for serious HFMD.
目的: 探讨手足口病（HFMD）患儿血清S100B蛋白和神经元特异性烯醇化酶（NSE）水平检测对预测HFMD严重程度的价值。
方法: 将90例HFMD患儿分为普通型、重型和危重型3组，每组30例；随机选取30例健康儿童作为对照组。ELISA法检测治疗前及治疗后7d血清S100B蛋白和NSE水平。采用受试者操作特征曲线（ROC曲线）评价S100B蛋白和NSE对HFMD严重程度的预测效能。
结果: 危重型HFMD患儿血清S100B蛋白和NSE水平均较其他3组明显升高（P < 0.01）；重型患儿血清S100B蛋白和NSE水平均较普通型和对照组明显升高（P < 0.01）。与治疗前比较，危重型组和重型组治疗后血清S100B蛋白及NSE水平明显下降（P < 0.05）。当血清S100B蛋白在0.445μg/L时其Youden值最大，为0.611，其对重症HFMD（包括重型和危重型HFMD）预测的灵敏度为61%，特异度为100%。血清NSE在5.905μg/L时其Youden值最大，为0.533，其对重症HFMD预测的灵敏度为80%，特异度为73%。两个指标并联检测的灵敏度为86%，特异度为73%，对预测重症HFMD的价值最高。
结论: 血清S100B蛋白和NSE有助于判断HFMD病情严重程度及治疗效果；二者如能并联检测对重症HFMD的预测价值更高。