肠道病毒71型感染对儿童心肌损害的影响

Clinical analysis of myocardial damage of EnteroviruS 71 （EV71） infection in children

目的探讨肠道病毒71型（EV71）感染对手足口病患儿心肌损害的影响。方法我院2010年5月至2011年9N收治的126例手足口病患儿分为EV71（＋）组和EV71（-）组、重症组和非重症组，分别比较EV71（＋）组和EV71（-）组之间、重症组和非重症组之间的心肌酶谱和心电图结果，。结果全部病例5项心肌酶均高于对照组，EV71（＋）组患儿的心肌酶与EV71（-）组比较差异无显著性（P〉0．05），重症组与非重症组比较，重症组心肌酶谱中肌酸激酶同工酶（CK-MB）为（43．65．4-13．78）U／L、乳酸脱氢酶（LDH）为（413．50-1-143．83）U／L、羟丁酸脱氢酶（HBDH）为（446．08±161．77）U／L，较非重症组均有明显升高（P〈0．05）心电图异常以窦性心动过速为主，EV71（＋）组心电图异常率与EV71（-）组比较差异无明显性（P〉0．05），重症组心电图异常率高于非重症组（P〈0．05）。结论手足口病患儿可出现心肌酶升高和心电图异常表现，存在心肌损害，但EV71感染对心肌损害与其他手足口病肠道病毒感染比较无显著差异，但心肌损害可作为发现重症病例的早期观察指标。

Objective To investigate myocardial damage of enterovirus 71 （EV71） infection on Hand-Foot-Mouth Disease（HFMD） children. Methods 126 HFMD cases deviced into EV71（＋） group and EV71（-） group, severe group and non-severe group.The myocardial enzymes and ECG results were compared between EV71（＋） group and EV71（-） group, severe group and non-severe group .Results Myocardial enzymesof all patients were increased. EV71（＋） group of enzymes was no significant differ- ence with EV71（-） group （P〉 0.05）, The severe group＇s myocardial enzyme creatine kinase （CK-MB） was 43.65± 13.78U/L, lactate dehydrogenase （LDH） was （413.50 ± 143.83）U/L, and hydroxybutyrate dehydrogenase （HBDH） was（446.08 ± 161.77）U/L, they compared with non-severe group was signifi- cantly higher （P〈 0.05）; Electrocardiogram（ECG） abnormalities was mainly Sinus tachycardia .The rate of abnormal ECG of EV71（＋） group compared with EV71（-） group was no significant difference（P〉 0.05）, the rate of severe group of ECG abnormalities was higher than non-severe group（P 〈0.05）.Conclusions Child patients with HFMD children may have Myocardial enzymes increases and ECG abnormalities, It exist myocardial damage, but EV71 infection compared with other HFMD enterovirus was no significant differences, but itcan seen as the early observation indicators of severe cases by myocardial damage.