Abstract: Objective To research the diagnostic value of serum neuron specific enolase (NSE) and catecholamine (CA) levels to severe hand foot mouth disease (HFMD) in children,and to provide reference for clinical evaluation of HFMD severity. Methods Totally 110 HFMD childen hospitalized in the Maternal and Child Health Care Hospital of Hainan Province from January 2014 to December 2015 were enrolled in this study.According to the Guide for the Diagnosis and Treatment of HFMD established in 2010 by the ministry of health,110 HFMD children were divided into mild group (44 cases),severe severe group (44 cases) and critical severe group (22 cases).The levels of NSE and CA were tested and compared among three groups.And the relationship between the levels of NSE,CA and the severity of HFMD was analyzed. Results 1)The levels of NSE and epinephrine(E),dopaminel (NE) in severe group were significantly higher than those in the mild group (Pˉ0.05).2) The levels of NSE and E,NE,DA in critical severe group were significantly higher than those in the severe severe group (Pˉ0.05).3)The levels of NSE,E,NE,DA levels were positively related to the severity of HFMD (r=0.366,0.590,0.425,0.345,all P<0.05). Conclusion The levels of NSE and NE would increase with the disease progressing.And the levels of NSE and NE can be used as a reference indicator to assess the severity of HFMD.

Key words: hand foot and mouth disease, severe, neuron specific enolase, catecholamine, children

摘要： 目的 研究手足口病（HFMD)患儿血清神经元特异性烯醇化酶(NSE)及儿茶酷胺（CA)水平对重症手足口 病的诊断价值，为临床上评估手足口病病情严重程度提供参考指标。方法 研究对象为2014年1月一201日年12月在海 南省妇幼保健院住院的110例手足口病患儿病例资料，按照卫生部颁发的手足口病诊疗指南（2010年版）分为轻症组（44 例'重症重型组（44例、重症危重型组（22例）。入院时检测患儿血清NSE、CA水平，分析其水平在轻症与重症重型、重 症重型与重症危重型么间的差异及其水平与手足口病病情严重程度的相关性。结果 1)重症重型组的NSE和肾上腺素 (E)、去甲肾上腺素（NE)水平均明显高于轻症组，差异有统计学意义（P<0.05）。2)重症危重型组的NSE和E、NE、多巴 胺(DA)水平均明显高于重症重型组，差异有统计学意义（P<0.05）。3)NSE、E、NE、DA水平与患儿手足口病病情严重程 度均呈正相关（r=0.366,0.590,0.425，0.345，P均<0.05）。结论 手足口病患儿的NSE和NE水平可随病情的进展而 升高。NSE和NE可作为评估手足口病病情严重程度的参考指标。

关键词: 手足口病, 重症, 神经元特异性烯醇化酶, 儿茶酚胺, 儿童