Study on the relationship between serum AQP4 and peripheral blood BMEC levels and the severity of HFMD in children and the predictive efficacy of myocardial injury

CHEN Lian; LAN Langzi; LIU Yajing

doi:10.3969/j.issn.1007-8134.2025.03.011

Abstract：Objective To investigate the relationship between the levels of serum aquaporin 4(AQP4)and peripheral blood cerebral microvascular endothelial cells(BMEC)and the severity of hand-foot-mouth disease(HFMD)in children,and the predictive efficacy of myocardial injury.Methods One hundred and sixteen children with HFMD treated in our hospital from January 2021 to July 2024 were selected as the observation group,including 36 cases of severe type and 80 cases of common type.Another 116 healthy children were selected as control group.The serum AQP4,interleukin-6(IL-6)and peripheral blood BMEC levels of all the participants were detected,and the relationship between the serum AQP4 and peripheral blood BMEC levels and the critical case score(PCIS),IL-6 in children with HFMD was analyzed.Myocardial injury was recorded in the observation group,serum AQP4 and peripheral blood BMEC levels were compared between the myocardial injury group and the non-myocardial injury group,and the predictive efficacy of serum AQP4 combined with peripheral blood BMEC on myocardial injury in children with hand,foot and mouth disease was analyzed using receiver operating characteristic curve(ROC).Results Serum AQP4 and peripheral blood BMEC levels in observation group were higher than those in control group(P＜0.05).Serum AQP 4,peripheral BMEC level and the incidence of myocardial injury were found in higher than the normal children(P＜0.05).By Pearson correlation analysis,serum AQP4 and peripheral blood BMEC levels were negatively correlated with PCIS score(r=-0.298,-0.301;P＜0.05),and positively correlated with serum IL-6 levels(r=0.337,0.356;P＜0.05).The levels of serum AQP4 and peripheral blood BMEC in myocardial injury group were higher than those in non-myocardial injury group(P＜0.05).ROC curve analysis showed that serum AQP4 combined with peripheral blood BMEC had a sensitivity of 91.52%,specificity of 63.74%and AUC of 0.907 in predicting myocardial injury in children with HFMD.Conclusion Serum AQP4 and peripheral blood BMEC levels are closely related to the severity of HFMD in children,the combined application of AQP4 and BMEC can further improve the prediction efficiency of myocardial injury in children.