赛若金联合无乳糖饮食对小儿轮状病毒感染性肠炎肠黏膜损伤及心肌酶谱的影响

Effect of Sinogen combined with lactose-free diet on rotavirus infectious enteritis intestinal mucosal lesions and myocardial enzymes of children

目的研究赛若金联合无乳糖饮食对小儿轮状病毒(RV)感染性肠炎肠黏膜损伤及心肌酶谱的影响。方法选取2015年10月-2016年10月在医院就诊的100例小儿轮状病毒感染性肠炎患儿,按照随机、对照、双盲试验原则分为观察组和对照组,各50例,对照组患儿采用注射用重组人干扰素α1b(赛若金)治疗,观察组患儿在此基础上联合无乳糖饮食治疗,通过临床总有效率、心肌酶谱、肠黏膜损伤相关指标、T淋巴细胞亚群等指标评估临床疗效。结果观察组患儿临床治疗有效率96.00%,明显高于对照组患儿84.00%(P<0.05);治疗后观察组患儿门冬氨酸氨基转移酶(AST)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBDH)值为(33.01±4.59)、(110.43±10.43)、(15.71±2.34)、(210.30±20.12)、(130.12±34.24)U/L,均低于对照组患儿(39.12±5.23)、(156.81±11.03)、(22.04±2.89)、(230.54±20.76)、(167.32±34.85)U/L,差异有统计学意义(P<0.05);治疗后观察组患儿血清中晚期糖基化终末产物(AGEs)、内毒素(EXT)、二胺氧化酶(DAO)值分别为(165.41±34.02)ng/L、(0.31±0.12)EU/ml、(0.54±0.11)U/L,均低于对照组(243.12±34.78)ng/L、(0.76±0.20)EU/ml、(1.56±0.13)U/L,差异有统计学意义(P<0.05);治疗后观察组患儿CD_3^+、CD_4^+、CD_4^+/CD_8^+值为(62.53±4.45)、(39.10±4.37)、(1.62±0.43),均高于对照组(57.01±4.79)、(35.22±4.87)、(1.44±0.34),观察组CD_8^+值(26.01±3.21),低于对照组(28.34±3.65),差异有统计学意义(P<0.05)。结论对小儿轮状病毒感染性肠炎患者,赛若金联合无乳糖饮食,有利于快速减轻腹泻、腹痛症状,改善肠黏膜损伤,保护心肌功能,增强免疫功能,提高治疗效果,值得临床积极推广和应用。

OBJECTIVE To explore the effect of Sinogen combined with lactose-free diet on rotavirus（RV）infectious enteritis intestinal mucosal lesions and myocardial enzymes of children.METHODS A total of 100 children with RV infectious enteritis who were treated in the hospital from Oct 2015 to Oct 2016 were enrolled in the study and divided into the observation group and the control group based on the randomized,controlled and double blind trial principles,with 50 cases in each group.The control group was treated with injection of recombinant human interferon α1 b,while the observation group was given the additional lactose-free diet therapy based on the treatment of the control group.The total effective rate,myocardial enzymes,intestinal mucosal lesion-related indexes and T lymphocyte subsets were evaluated to determine the clinical efficacy.RESULTS The effective rate of clinical treatment of the observation group was 96.00% ,significantly higher than 84.00% of the control group（P0.05）.The levels of aspartate aminotransferase（AST）,creatine kinase（CK）,creatine kinase isoenzyme（CKMB）,lactate dehydrogenase（LDH）andα-hydroxybutyrate dehydrogenase（α-HBDH）of the observation group were respectively（33.01±4.59）,（110.43±10.43）,（15.71±2.34）,（210.30±20.12）and（130.12±34.24）U/L after the treatment,significantly lower than（39.12±5.23）,（156.81±11.03）,（22.04±2.89）,（230.54±20.76）and（167.32±34.85）U/L of the control group（P0.05）.The levels of serum advanced glycation end products（AGEs）,endotoxin（EXT）and diamine oxydase（DAO）of the observation group were respectively（165.41±34.02）ng/L,（0.31±0.12）EU/ml and（0.54±0.11）U/L after the treatment,significantly lower than（243.12±34.78）ng/L,（0.76±0.20）EU/ml and（1.56±0.13）U/L of the control group（P0.05）.The levels of CD3^＋,CD4^＋and CD4^＋/CD8^＋of the observation group were respectively（62.53±4.45）,（39.10±4.37）and（1.62±0.43）after the treatment,significantly higher than（57.01±4.79）,（35.22±4.87）and（1.44±0.34）of the control group,the CD8^＋level of the observation group was（26.01±3.21）,significantly lower than（28.34±3.65）of the control group（P0.05）.CONCLUSION As for the children with RV infectious enteritis,the recombinant human interferon α1 bcombined with lactose-free diet may facilitate the rapid relief of diarrhea and abdominal pain symptoms,improve the intestinal mucosal lesions,protect the myocardial function,boost the immune function and improve the curative effect.It is worthy to be promoted in the hospital.