手足口病合并心肌损害患儿的心电图特点及临床意义

Electrocardiograph features and its clinical value in children with hand-foot-mouth disease combined with myocardial injury

目的研究手足口病患儿的心肌酶活性及心电图表现，为临床诊疗提供参考。方法将120例确诊的手足口病患儿作为观察对象，同时按1：1标准选取120例健康儿童作为对照，所有患儿入院后第二天清晨抽取静脉血行心肌酶检测，同时行常规12导联心电图检查，比较两组患儿治疗前后心电图及心肌酶学的差异。结果观察组患儿肌酸激酶同工酶（CK—MB）、乳酸脱氢酶（LDH）、天冬氨酸氨基转移酶（AST）、α羟丁酸脱氢酶（HBDH）水平高于对照组，差异有统计学意义（P〈0．05）；治疗前后患儿肌酸激酶同工酶（CK—MB）、乳酸脱氢酶（LDH）、肌酸激酶（CK）、天冬氨酸氨基转移酶（AsT）、d羟丁酸脱氢酶（HBDH）水平逐渐降低（P〈0．05）；治疗前患儿心电图异常情况主要有窦性心动过速、ST—T改变、传导阻滞及早搏等，治疗后表现为心电图异常率明显降低，主要表现为T波双向或低平。结论对心电图和心肌酶的检查可早期发现手足口病患儿的心肌损害，对早期诊疗和预后具有积极意义。

Objective To assess the features of myocardial enzyme and electrocardiograph （ECG） in the children with hand-foot-mouth disease （HFMD）. The result of our research maybe could provide a kind of method to diagnose and promote earlier therapy in HFMD. Methods This was a cross-sectional study of analyzing 120 children diagnosed as HFMD, while another 120 healthy children were defined as the control group. All participants had the ECG examination and were taken the blood sample to test the myocardial enzyme level before and after the treatment. ECG and myocardial enzyme level in two groups were respectively performed. Results Creatine kinase （CK- MB）, lactate dehydrogenase （LDH）, acid aspartate aminotransferase （AST）, α hydroxybutyrate dehydrogenase High （HBDH） Horizontal in children with HFMD were higher in contrast to those of the control group, and the differences were statistically significant （P 〈 0.05）. CK-MB, LDH, CK, AST, HBDH levels decreased when the children got the treatment （P 〈 0.05）. Before getting the treatment, ECG abnormalities of the children with HFMD mainly concluded tachycardia, ST-T changes in conduction block and premature contraction, etc., which showed significantly lower rates of appearance after being treated, but someone still had a two-way or flat T waves. Conclusion As for the earlier diagnosis, treatment and improving the prognosis of HFMD, it is great valuable to have the ECG examination to test myocardial enzyme level earlier.