小儿病毒性脑炎与血清心肌酶谱和NSE的相关性分析

Correlation of viral encephalitis with serum myocardial enzymes and NSE

目的探讨血清心肌酶谱对病毒性脑炎患儿病情严重性及预后的影响。方法选取于2014年2月至2017年2月来蓬莱市人民医院治疗的病毒性脑炎患儿70例作为观察组,选取同期体检的62例正常儿童为对照组,检测所有患儿血清天门冬氨酸氨基转移酶(AST)、肌酸激酶(CK)、肌酸激酶心型同工酶(CK-MB)、乳酸脱氢酶(LDH)、神经元特异性烯醇化酶(NSE)水平,并对观察组患儿α-羟丁酸脱氢酶(α-HBDH)水平进行检测记录。分析比较对照组与观察组、轻型脑炎与重型脑炎、观察组中急性期与恢复期、非丙球治疗组与丙球治疗组间心肌酶谱存在的差异。结果A组的临床总有效率(86.21%)低于B组(100.00%),差异有统计学意义(χ~2=4.296,P<0.05)。经相关性分析,病毒性脑炎患儿的CK-MB与AST、LDH、NSE和α-HBDH均有相关性(r值分别为0.258、0.152、0.291、0.283,均P<0.05)。B组患儿的AST、LDH、CK、CK-MB、α-HBDH、NSE水平均明显低于A组患儿(t值分别为5.359、4.790、3.588、8.667、11.866、3.418,均P<0.05)。结论血清心肌酶谱及NSE可作为临床评估病毒性脑炎患儿病情严重性及预后的重要指标,治疗时应随时关注患儿心肌酶谱及NSE数值的变化,并及时给予患儿针对性的治疗。

Objective To investigate the influence of serum myocardial enzymes on severity and prognosis of children with viral encephalitis.Methods Seventy children with viral encephalitis treated in Penglai People＇s Hospital from February 2014 to February2017 were selected in observation group,and 62 cases of normal children were selected in control group.Serum levels of aspartate aminotransferase（AST）,creatine kinase（CK）,creatine kinase-MB isoenzyme（CK-MB）,lactate dehydrogenase（LDH）and NSE were detected,andα-hydroxybutyric acid dehydrogenase（α-HBDH）of children in the observation group was also detected and recorded.The differences in myocardial enzymes between the control group and the observation group,mild encephalitis and severe encephalitis,acute phase and recovery stage in observation group,gammaglobulin treatment and non-treatment group were analyzed.Results Total effective rate of group A（86.21%）was lower than that（100.00%）of group B,and the difference was statistically significant（χ~2=4.296,P〈0.05）.The correlation analysis showed that CK-MB of children with viral encephalitis was related to AST,LDH,NSE andα-HBDH（r value was 0.258,0.152,0.291 and 0.283,respectively,all P〈0.05）.The levels of AST,LDH,CK,CK-MB,α-HBDH and NSE in group B were significantly lower than those in group A（t value was 5.359,4.790,3.588,8.667,11.866 and 3.418,respectively,all P〈0.05）.Conclusion Serum myocardial enzymes can be taken as an important indicator to assess the severity and prognosis of viral encephalitis.Change of myocardial enzymes and NSE in children should be focused and targeted treatment needs to be given timely.