Study on intestinal barrier function in children with different severity of hand - foot - mouth disease

Objective To analyze the changes of levels of plasma diamine oxidase(DAO), D-lactate and endotoxin in children with different severity of hand-foot-mouth disease(HFMD), explore the changes of the function of intestinal mucosal barrier in children with HFMD, and investigate the sensitivity and early warning effect of the indexes described previously on the damage of intestinal mucosal barrier in children with severe HFMD. Methods Four hundred and seventy inpatient children in Xi′an Children′s Hospital from March 2016 to June 2017 suffered from HFMD were selected as the study group , and one hundred healthy children were selected as the control group in the same period.Children in the study group were divided into common group (n=300), severe group(n=110)and critical condition group(n=60)according to the severity of the disease.The levels of plasma DAO, D-lactate and endotoxin from children in each group were compared. Results The plasma D-lactate level of the children in the study group was significantly higher than that in the control group, and the difference was statistically significant[(27.670±6.273)mg/L vs.(25.585±5.177)mg/L; t=3.515, P 0.05; (1.186±0.486)U/L vs.(1.091±0.494)U/L, P>0.05]. The comparison of multiple groups showed that the difference of plasma D-lactate levels was statistically significant(F=33.488, P 0.05). The level of plasma D-lactate in critical condition group[(32.502±4.756)mg/L] was significantly higher than those in the severe group[(29.872±6.468)mg/L], the common group[(25.896±5.691)mg/L] and the control group, and the differences were statistically significant(P 0.05). Conclusion The intestinal permeability and intestinal mucosal barrier are impaired in children with severe and critical HFMD.Plasma D-lactate is significantly elevated in the early stage of intestinal barrier injury.Compared with DAO and endotoxin, D-lactate is a sensitive and early warning index suggesting the impaired intestinal mucosal barrier function in severe and critical cases of HFMD. Key words: Hand-foot-mouth disease; Intestinal barrier function; Diamine oxidase; D-lactate; Endotoxin