Study on the relationship between high mobility group protein 1 and the severity of enterovirus 71 hand, foot and mouth disease / 中国小儿急救医学

ABSTRACT

Objective:To study the relationship between the level of high mobility group protein 1(HMGB1)and the severity of hand, foot and mouth disease (HFMD).Methods:A total of 150 children with enterovirus 71(EV71) HFMD admitted to Xi′an Children′s Hospital from April 2018 to December 2019 were selected as the study objects, including 100 mild cases(normal group) and 50 severe cases(severe group). Meanwhile, 50 healthy children during the same period were selected as control group.The level of HMGB1 in plasma was detected by ELISA.The clinical data and laboratory examination of the case group were collected.The factors that may affect the conversion of HFMD to severe were analyzed by single factor and multi-factor Logistic regression analysis.The risk factors of conversion of HFMD to severe and the correlation between the level of HMGB1 in plasma and the severity of HFMD were discussed.Results:The level of HMGB1 in EV71 HFMD children in the acute stage[(13 700±3 036)pg/mL] was significantly higher than that in the control group[(10 116±2 435) pg/mL]( t=5.913, P<0.05). After treatment, the level of HMGB1 decreased in the convalescence period[(10 658±2 349) pg/mL], and the difference was not statistically significant compared with the control group ( t=2.515, P>0.05). Blood glucose, white blood cell count and HMGB1 level in the severe group were all higher than those in the normal group (all P<0.05). Multivariate Logistic regression analysis found that the levels of blood glucose >8.3 mmol/L, peripheral blood leukocyte >15×10 9/L, and HMGB1≥ 13 110 pg/mL were the risk factors for severe aggravation of HFMD in children.The receiver operating characteristic curve analysis showed that when HMGB1 was 13 110 pg/mL, the Yoden index was the highest, with a sensitivity of 81.6% and a specificity of 72.0%. Conclusion:WBC>15×10 9/L, blood glucose>8.3 mmol/L and HMGB1≥13 110 pg/mL are the risk factors of HFMD.When HMGB1 is higher than, it suggests that HFMD may develop to severe.