RV肠炎及伴心肌损害患儿血浆PCT、CRP及hsCRP水平的变化及意义

Level changes and significance of PCT,CRP and hs CRP in children with rotavirus enteritis complicated heart lesion

目的观察急性轮状病毒(RV)肠炎及伴心肌损害患儿血浆降钙素原(PCT)、C反应蛋白(CRP)及超敏C反应蛋白(hs CRP)水平的变化,并探讨其意义。方法根据有无心肌损害将72例RV肠炎患儿分为RV肠炎无心肌损害组(37例)和伴心肌损害组(35例),健康体检儿童45例为对照组,分别用免疫层析法检测各组血清PCT,用免疫荧光法检测CRP、hs CRP。结果 RV肠炎伴心肌损害组PCT、CRP及hs CRP(0.75 ng/ml±0.64 ng/ml、17.34 mg/L±10.07 mg/L、11.42 mg/L±6.83 mg/L)均高于不伴心肌损害组(0.22 ng/ml±0.13 ng/ml、8.90 mg/L±2.94 mg/L、1.60 mg/L±1.33 mg/L)及健康对照组(0.08 ng/ml±0.37 ng/ml、7.32 mg/L±3.03 mg/L、0.165 mg/L±0.082 mg/L),差异均有统计学意义(P<0.05)。不伴心肌损害组PCT及hs CRP明显高于正常对照组(P<0.05),两组间CRP差异无统计学意义(P>0.05)。在RV感染腹泻患儿中,当hs CRP的临界值(cut-off值)取1.0 mg/L时,其诊断心肌损害的敏感度和特异度分别为92.9%、67.0%。结论 RV肠炎伴心肌损害患儿血浆PCT、CRP及hs CRP水平增高,三者与心肌损害的发生有关,共同参与了肠炎的发生、发展;早期检测hs CRP有助于心肌损害的诊断。

Objective To observe the level changes of procalcitonin（ PCT）,C- reactive protein（ CRP） and high- sensitivity C- reactive protein（ hs CRP） in acute rotavirus（ RV） infection children with heart lesion. Methods According to whether complicated heart lesion or not,72 cases of RV enteritis were divided into no heart lesion group（ 37 cases） and heart lesion group（ 35 cases）. Selected 45 cases of helthy children as the control group. PCT of each group was measured with immunochromatographic test. CRP and hs CRP were measured with immunofluorescence. Results PCT,CRP and hs CRP concentration in heart lesion group（ 0. 75 ng / ml ± 0. 64 ng / ml,17. 34 mg / L ± 10. 07 mg / L,11. 42 mg / L ± 6. 83 mg / L） was higher than those of the group without heart lesion（ 0. 22 ng / ml ± 0. 13 ng / ml,8. 90 mg / L ± 2. 94 mg / L,1. 60 mg / L ± 1. 33 mg / L） and the healthy control group（ 0. 08 ng / ml ± 0. 37 ng / ml,7. 32 mg / L ± 3. 03 mg / L,0. 165 mg / L ± 0. 082 mg / L）. The differences among the three groups were statistically significant（ P〈0. 05）. PCT and hs CRP concentration of the group without heart lesion was higher than the healthy control group（ P〈0. 05）. The difference of CRP between them was statistically significant（ P〉0. 05）. In the diagnosis of heart lesion of RV infection children by hs CRP,when the threshold（ cut- off value） was1. 0 mg / L,the sensitivity and specificity were 92. 4% and 67. 0% respectively. Conclusion In children with RV enteritis,the increasing of PCT,CRP and hs CRP serum concentration may be correlated with the heart lesion,which may participate in the occurrence and development of RV enteritis. It＇s helpful to diagnose heart lesion in RV infection children by early detecting of hs CRP.