手足口病患儿心肌损伤的观察及其临床意义

The observations and clinical significance of myocardial injuries on HFMD

目的：探讨手足口病患儿血清NT-proBNP、 心肌酶谱以及心电图的变化及其临床意义.方法：43例临床确诊的手足口病患儿作为观察组,测定所有患儿NT-proBNP及心肌酶谱中AST、LDH、CK、CK-MB和α-HBDH的血清水平,同时予以心电图检查.同期30例无器质性疾病的健康体检儿童作为正常对照组.结果：观察组患儿血清NT-proBNP及AST,LDH,CK,CK-MB和α-HBDH分别为182.2±61.6 pg/ml,61.2±11.9 U/L,275.3±102.6 U/L,247.0±121.5 U/L,33.2±12.5 U/L和283.2±92.4 U/L,均明显高于正常对照组（P〈0.01或P〈0.05）.观察组心电图表现以ST-T改变和窦性心动过速为主（P〈0.05）.结论：联合监测血清NT-proBNP、心肌酶谱水平以及心电图的变化对该病病情的评估、 预后的预测均具有重要的临床意义.

Objective： To study the changes and clinical significance of serum NT-proBNP, myocardial enzymes and ECG in children who suffered with HFMD （hand-foot and mouth disease, HFMD）. Methods： 43 cases of HFMD children diagnosed by clinic were assigned to the object of study. The levels of serum NT-proBNP and myocardial enzymes were determined by Pylon Core and Hitachi 7600 respectively. ECG was performed by an electrocardiograph. Meanwhile, 30 healthy physical examination children without organic disease of the corresponding period were enrolled in the control group. Results： Compared with the healthy control group, the level of serum NT-proBNP and myocardial enzymes AST, LDH, CK, CK-MB and α-HBDH in observation group were 182.2±61.6 pg/ml, 61.2± 11.9 U/L, 275.3±102.6 U/L, 247.0 ±121.5 U/L, 33.2 ±12.5 U/L and 283.2 ±92.4 U/L respectively, and the difference were statistically significant（P〈0.01 or P〈0.05） . The ECG in the study group mainly showed the changes in ST-T and sinus tachycardia. Conclusion： To determine the level of serum BNP, myocardial enzymes AST, LDH, CK, CK-MB and α-HBDH, together with ECG was very important and clinically significant for HFMD children to assess disease and prognosis.