婴幼儿腹泻致心肌损伤相关因素及评估

The Related Factors and Assessment of Key Points of Myocardial Damage Induced by Diarrhea in Infants

目的:探讨应用心肌酶和肌钙蛋白I评估婴幼儿腹泻发生心肌损伤的相关因素及评估要点。方法:对216例婴幼儿腹泻的心肌酶及肌钙蛋白I分年龄及临床症状、病因组进行分类对比分析。结果:轮状病毒肠炎心肌酶及肌酸激酶同工酶(CK-MB)、肌钙蛋白I改变明显,轮状病毒肠炎心肌酶异常达76.32%;并发CK-MB升高达59.21%;肌钙蛋白I升高27.63%,与非感染性腹泻、细菌性腹泻、其它病毒性腹泻相比较,分别为心肌酶异常占30.56%(p<0.01);47.92%(p<0.01),67.86%(p>0.05),并发CK-MB升高分别为8.33%(p<0.01);14.58%(p<0.01);42.86%(p<0.05)。肌钙蛋白I升高分别为2.78%(p<0.01);6.25%(p<0.01);14.29%(p<0.05)。结论:婴幼儿腹泻病以轮状病毒性肠炎致心肌损伤危害最大,其他病毒性肠炎其次。心肌酶肌酸激酶同工酶(CK-MB)增高率与年龄成反比,与发热、脱水、酸中毒、腹泻种类及程度有关。心肌酶和肌钙蛋白I联合检测和结合临床症状等综合评估才能准确诊断婴幼儿腹泻致心肌损伤。

Objective：To study the assessment of myocardial enzymes and troponinl of infantile diarrhea associated factors of myocardial damage and assessment points. Methods： Comparative analysis on 216 cases classified infantile diarrhea enzyme and troponin I by age, clinical symptoms and causes. Results： Rotavirus enteritis and creatinekinase enzyme （CK-MB） , troponin I changed obviously, abnormal rotavirus enzyme went up to 76.32% , v, ith concurrent increase in CK-MB up to 59.21% ; troponin I Increased 27.63% , and non- infectious diarrhea, bacterial diarrhea, viral diarrilea compared to the other, respectively, accounted for the abnormal enzyme 30.56% （p〈0. 01）; 47.92% （p 〈0.01）;67.86% （p 〉0.05）. Concurrent increase in C K-MB was 8.33% （p 〈0.01）; 14.58% （p〈0.01）;42.86% （p〈0.05）.elevatedtrnponinlwas2.78% （p〈0.01）; 6.25 % （p〈0.01）; 14.29% （p〈0.05）. Conclusion： Diarrhea in infants with rotavints enteritis induced serious myocardial damage, followed by other viral enteritis. Enzyme creatine kinase （CK-MB） increased in inverse proportion with age, with fever, dehydration, acidosis, diarrhea type and degree. Combined detection of myocardial enzymes and troponin I, combined with comprehensive assessment of clinical symptoms can make accurate diagnosis of myocardial damage induced by diarrhea in infants.