关键词: 手足口病, ghrelin, 胃肠功能障碍, D-乳酸, 内毒素, 前降钙素

Abstract: Objective To investigate the relationship between serum ghrelin and gastrointestinal dysfunction in children with different severity of hand-foot-mouth disease (HFMD),in order to provide reference for clinical treatment of HFMD. Methods A total of 130 children with HFMD admitted to Wuxi Children′s Hospital from September 2016 to October 2018 were selected as the study group,and 60 healthy children who took physical examination at the same period were selected as healthy group.The venous blood of the participants was collected in the morning,the levels of serum ghrelin,D-lactate,endotoxin and procalcitonin (PCT) were tested,and the gastrointestinal failure (GIF) score was evaluated.Pearson correlation analysis was used to analyze the correlations of ghrelin,D-lactate and endotoxin with PCT.And the values of ghrelin,D-lactate,endotoxin and PCT in the diagnosis of HFMD were analyzed by receiver operating curve (ROC).Logistic regression analysis was conducted to determine the factors that might affect the occurrence of HFMD. Results Serum level of ghrelin of the study group was significantly lower than that of the healthy group (t=17.764,P＜0.05),while the GIF score and the serum D-lactate,endotoxin and PCT levels were significantly higher than those of healthy group (t=26.112,14.324,15.491,23.433,P<0.05).Serum ghrelin level in critical HFMD children and severe HFMD children was significantly lower than that of typical HFMD children,and serum level of ghrelin was significantly lower in critical HFMD children than severe HFMD children (F=105.761, P<0.05).Moreover,GIF score,the levels of serum D-lactate,endotoxin and PCT in critical HFMD children and severe HFMD children were significantly higher than typical HFMD children,and those indexes were higher in critical HFMD children than severe HFMD children (P<0.05).Pearson correlation analysis showed that serum ghrelin level was negatively correlated with GIF score,serum D-lactic acid,endotoxin and PCT in HFMD children (r=-0.549,-0.563,-0.667,-0.581, P<0.05).The areas under the curve (AUC) for ghrelin,D-lactake endotoxin and PCT were 0.868,0.867,0.750 and 0.846.Logistic regression analysis showed that ghrelin,D-lactate,endotoxin and PCT were all risk factors for HFMD. Conclusion Serum ghrelin level is closely related to the severity of HFMD and gastrointestinal function,and decreases with the increasing of severity of HFMD.

Key words: hand-foot-and-mouth disease, ghrelin, gastrointestinal dysfunction, D-lactate, endotoxin, procalcitoin