血清心肌酶检测对儿童轮状病毒性肠炎合并心肌损伤的诊断意义

Clinical Significance of Serum Myocardial Enzyme Detection in Children with Rotavirus Enteritis and Myocardial Injury

目的探究轮状病毒性肠炎伴心肌损伤患儿临床以血清心肌酶检测诊断的有效性。方法方便选取2015年12月—2017年4月期间因急性腹泻入该院治疗的194例患儿为研究对象,根据轮状病毒抗原检测结果,分为观察组轮状病毒(RV)阳性,人数102例;对照组(RV阴性),人数92例,同时根据RV阳性组患儿有无脱水情况将观察组分为无脱水组(60例)、脱水组(42例),所有患儿入院后抽取肘静脉血进行血清心肌酶检查,同时进行心电图检查,观察各组患儿心肌酶指标[α-羟丁酸脱氢酶(α-HBDH)、同功酶(CKMB)、乳酸脱氢酶(LDH)、天门冬氨酸氨基转移酶(AST)、肌酸激酶(CK)]水平差异。结果观察组CK、AST、LDH、CKMB、α-HBDH指标值分别为(246.87±50.31)、(66.24±20.06)、(318.46±30.85)、(67.38±10.70)、(190.57±25.40)U/L,对照组分别为(157.04±37.28)、(31.47±2.52)、(200.43±20.57)、(7.58±2.43)、(148.30±10.38)U/L,观察组指标值高于对照组(t=14.005,16.504,31.000,52.389,2.579,P<0.05);脱水组CK、AST、CKMB、α-HBDH指标值分别为(246.87±50.31)、(78.64±8.16)、(280.46±12.85)、(75.64±9.16)、(251.62±12.40)U/L,无脱水组分别为(157.04±37.28)、(54.27±4.63)、(251.84±10.36)、(61.75±9.06)、(183.52±13.08)U/L,脱水组指标值高于无脱水组(t=10.359,19.165,12.428,10.601,26.433,P<0.05);脱水组患儿心肌损伤发生率为33.3%高于无脱水组13.3%,(χ~2=11.191,P<0.05)。结论通过对RV肠炎患儿进行血清心肌酶检查,能初步判断患儿心肌损伤程度,利于临床及时采取有效治疗措施。

Objective To investigate the clinical validity of serum myocardial enzymes detection in children with rotavirus enteritis and myocardial injury. Methods A total of 194 children with acute diarrhea admitted to our hospital during the period of December 2015 to April 2017 were convenient selected as study subjects. According to the results of rotavirus antigen detection, the patients were divided into observation group with rotavirus（RV） positive and number of 102 patients;control group（RV Negative）, the number of 92 cases, according to the presence or absence of dehydration in the RV-positive group, the observed components were no dehydration group（60 cases）, dehydration group（42 cases）, all patients were admitted to the hospital after taking blood from the elbow vein serum myocardial Enzyme examination, electrocardiogram examination at the same time, observed in each group of children with myocardial enzymes indicators [alpha-hydroxybutyrate dehydrogenase（alpha-HBDH）, isozyme（CKMB）, lactate dehydrogenase（LDH）, aspartic acid Differences in aminotransferase（AST）, creatine kinase（CK） levels. Results The values of CK, AST, LDH, CKMB and α-HBDH in the observation group were（246.87 ±50.31）,（66.24 ±20.06）,（318.46 ±30.85）,（67.38 ±10.70）,（190.57 ±25.40）U/L, control group（157.04 ±37.28）,（31.47±2.52）,（200.43±20.57）,（7.58±2.43）,（148.30±10.38）U/L, index value in observation group was higher than control group（t =14.005, 16.504, 31.000,52.389,2.579, P 0.05; dehydration group CK, AST, The index values of CKMB and α-HBDH were（246.87 ±50.31）,（78.64 ±8.16）,（280.46 ±12.85）,（75.64 ±9.16）,（251.62 ±12.40）U/L, no dehydration group were（157.04±37.28）,（54.27±4.63）,（251.84±10.36）,（61.75±9.06）,（183.52±13.08）U/L, the index value of the dehydration group was higher than that of the no dehydration group（t=10.359,19.165, 12.428,10.601,26.433, P〈0.05）; The incidence of myocardial damage in the dehydrated group was 33.3%. It was 13.3% higher than that in the non-dehydration group（χ^2=11.191, P〈0.05）. Conclusion Serum myocardium was administered to children with RV enteritis Enzymatic examination can initially determine the degree of myocardial damage in children, which is conducive to effective clinical treatment measures.