血清神经功能指标及心肌酶谱在病毒性脑炎患儿中的变化研究

Study on the changes of serum nerve function index and myocardial enzyme spectrum in children with viral encephalitis

目的观察血清神经功能指标及心肌酶谱在病毒性脑炎患儿中的变化,分析其在病情判断中的意义。方法 2014年1月~2015年10月在我院就诊的病毒性脑炎患儿123例,根据临床病情的轻重分为轻症病脑组（n=87）和重症病脑组（n=36）,并选取同时期健康儿童30例作为对照组,比较各组间血清神经功能指标及心肌酶谱水平差异。结果病毒性脑炎患儿血清神经功能相关指标S100B、NSE、MBP、NGF水平和心肌酶谱相关指标CK、CK-MB、AST、LDH水平显著高于对照组（均P〈0.05）,而且重症病脑组患儿血清中神经功能相关指标S100B、NSE、MBP、NGF水平和血清心肌酶谱相关指标CK、CK-MB、AST、LDH水平均显著高于轻症病脑组（均P〈0.05）。经治疗后,患儿各指标水平均有下降,入院后第1、2周S100B、NSE、MBP、NGF水平均显著低于治疗前（均P〈0.05）。结论在病毒性脑炎的诊疗中,神经功能指标和心肌酶活性均能用作判断疾病严重程度及转归的重要指标。

Objective To study the changes of serum nerve function index and myocardial enzyme spectrum in children with viral encephalitis,and to analysis the significance of these indicators in the diagnosis of disease.Methods Collected 123 cases of children with viral encephalitis in our hospital from January 2014 to October2015,these children were divided into mild viral encephalitis group（n=87）and severe viral encephalitis group（n=36）according to the severity of the clinical condition,then select normal healthy children 21 cases as control group.Then the difference of serum nerve function index and myocardial enzyme spectrum between groups were compared. Results The serum levels of nerve function index such as S100 B,NSE,MBP,NGF and myocardial enzyme spectrum such as CK,CK-MB,AST,LDH of children with viral encephalitis were all higher than those in normal healthy children（P〈0.05）;these indicators began to decline after appropriate treatment,the serum levels of S100 B,NSE,MBP,NGF and CK,CK-MB,AST,LDH of one week,two weeks after admission were all significantly lower than before treatment（P〈0.05）.The serum levels of nerve function index such as S100 B,NSE,MBP,NGF and myocardial enzyme spectrum such as CK,CK-MB,AST,LDH of severe viral encephalitis group were all higher than those of mild viral encephalitis group on admission（P〈0.05）. Conclusion Nerve function index and myocardial enzyme spectrum could be used as important indexes to judge the severity and prognosis in the diagnosis and treatment of viral encephalitis.