肠道病毒71型IgM阳性手足口病患儿70例心肌酶谱的临床观察

Clinical observation on serum myocardial enzymes in children with enterovirus 71 IgM positive hand-foot-mouth disease.

目的了解肠道病毒71型(EV71)IgM阳性手足口病患儿心肌酶谱的改变及其临床意义。方法对我市2009年3～4月收治的EV 71IgM阳性的足口病患儿进行心肌酶谱:天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)进行检测并分析其临床意义。结果70例EV 71IgM阳性手足口病患儿有66例有一项或多项心肌酶谱异常,占94.3%;其中CK-MB单项异常24例,占34.28%;LDH、CK-MB两项项异常25例,占35.71%;CK、CK-MB两项项异常5例,占7.14%;AST、LDH、CK、CK-MB四项项异常5例,占7.14%;LDH、CK、CK-MB三项异常6例,占8.6%;AST、LDH、CK-MB三项异常1例,占1.42%;四项全正常者4例,占5.7%。结论EV71IgM阳性手足口病患儿大部分心肌酶谱异常,可能存在心肌损害。

Objective To analyze changes of serarn myocardial enzymes in children with Enterovirus 71 IgM positive patients suffered with hand - foot - mouth disease （ HFMD）. Methods Serum myocardial enzymes and electrocardiogram in 70 cases with Enterovirus 71 lgM positive HFMD were examined. Myocardial enzymes included aspartate aminotransferase （AST） , lactate dehydrogenase （LDH） , creatine kinase （CK） and isoenzymes of creatine kinase （ CK - MB）. Results In 70 cases, 66 （94.3%） had one or more kinds of abnormal myocardial enzyme levels in serum. Among these patients, 24 （34.28%） had abnormal level of creatine kinase （ CK - MB） , 25 （35.71% ） were abnormal both in LDH and CK - MB, 5 （7. 14% ） were abnormal in both CK and CK - MB, 6 （8.6%） were abnormal in LDH, CK and CK - MB, 1 （ 1.42% ） was abnormal in AST, LDH and CK - MB, and 5 （7.14%） were abnormal in all levels of AST, LDH, CK and CK - MB. Conclusion There are one or more kinds of abnormal zymogram in myocardial enzymes in children suffered with Enterovirus 71 IgM positive HFMD.