To investigate the application value of early childhood warning combined with dynamic monitoring of C-reactive protein (CRP) and procalcitonin (PCT) in shunt diagnosis of children with hand, foot and mouth disease (HFMD).

From March 2015 to April 2019, a total of 102 children diagnosed as HFMD in Department of Pediatrics of Hanzhong People’s Hospital of Shaanxi Province were divided into ordinary group (58 cases) and severe group (44 cases) according to the severity condition; While 60 healthy children from physical examination center of the hospital were selected as control group. The levels of CRP, PCT, neutrophil ratio and lymphocyte percentage were detected of children in ordinary group and severe group. Overall comparison of the above indicators at admission, the 3rd day and 7th day after treatment were analyzed by repeated measures ANOVA, while comparison between every two groups were analyzed by LSD-t test.

There were no significant differences in age, course of disease, distribution and incidence of complications among cases of three groups (all P > 0.05), but the total incidence of complications of cases in severe group (40.90%) was significantly higher than that of the ordinary group (24.14%), with significant difference (χ² = 1.685, P = 0.045). PEWS scores were performed on all 102 children with HFMD at the time of enrollment, which were significantly higher in severe group than those of ordinary group, with significance differences (all P < 0.05). The levels of serum CRP and PCT among all three groups at the time of enrollment were significantly different (F = 111.079, 122.299; both P < 0.001). Pairwise comparison showed that serum levels of CRP and PCT of cases in severe group were significantly higher than those of ordinary group and control group, with significant differences (all P < 0.05). There were significant differences of PCT, CRP, neutrophil percentage and lymphocyte percentage in severe group and ordinary group by intra-group comparison (time dimension) (all P < 0.05), and the above indexes between severe group and ordinary group were significantly different (all P < 0.05). The levels of PCT, CRP, neutrophil percentage and lymphocyte percentage of cases in ordinary group and severe group were all significantly changed after treatment; the levels of the above indexes after treatment (7 d) were all with significant differences compared with those of admission into the group (all P < 0.05). There were significant differences of PCT, CRP levels and neutrophils percentage between ordinary group and severe group at each time point (all P < 0.05). The interaction analysis of time on groups showed that PCT level (F = 16.403, P < 0.001) and lymphocyte percentage (F = 4.296, P = 0.040) gradually decreased with the disease progression.

The detection of children’s serum CRP and PCT combined with early childhood warning scores had significant significance on clinical diagnosis and treatment of pediatric HFMD, which was helpful for clinicians to evaluate the severity of the disease. When serum CRP and PCT levels increased in a short time, in-depth observation and prevention should be carried out immediately to avoid further deterioration.