病毒性心肌炎患儿外周血中心功能、心肌酶谱指标、核因子-κB表达量的变化及核因子-κB与病情的相关性研究

Study on the changes of peripheral blood central function,myocardial enzymes and expression of nuclear factor-kappa B in children with viral myocarditis

目的探讨病毒性心肌炎(VMC)患儿外周血中核因子-κB(NF-κB)表达量的变化及其与病情的相关性,为VMC患儿的临床诊治提供参考。方法选择VMC患儿106例,根据病情将其分为休克组、心衰组和无心衰组,并取同期我院门诊外科32例患儿作为对照组。观察不同组别患者的心功能指标、血清心肌酶谱指标及外周血中NF-κB水平的变化,并采用Spearman等级分析法对VMC患儿外周血中NF-κB与其病情的相关性进行分析。结果对于VMC患者,按照无心衰组、心衰组及休克组的等级分组顺序,其EF异常率、LVFS异常率、LAD值、LVESD值、ALT、AST、LDH、cTnI、CK-MB、CK及NF-κB表达水平均明显升高,且均明显高于对照组(P<0.05)。采用Spearman等级相关性分析法进行分析,VMC患儿外周血中NF-κB表达水平与VMC患儿分组呈现等级正相关(P<0.05)。结论 VMC患儿外周血中NF-κB表达水平与VMC患者分组呈现等级正相关,可以作为VMC患者病情程度判定的重要参考指标。

Objective To investigate the changes of nuclear factor-κB(NF-κB)expression in peripheral blood of children with viral myocarditis and its correlation with the disease,and provide reference for the clinical diagnosis and treatment of children with viral myocarditis.Methods Total of 106 patients with viral myocarditis admitted from March 2016 to March 2018 as subjects,and divided them into shock group,heart failure group and non-heart failure group according to the condition.And 32 cases of outpatient surgery in our hospital were taken as the control group.The cardiac function indexes,serum myocardial zymograms and NF-κB levels in peripheral blood were observed in different groups.The correlation between NF-κB and its condition in peripheral blood of children with viral myocarditis was analyzed by Spearman rank analysis.Results For VMC patients,according to the group without heart failure,heart failure group and shock level grouping sequence,the EF abnormal rate and abnormal LVFS rate,LAD value,LVESD,ALT,AST,LDH,cTnI,CK-MB,CK and nf-kappa B expression levels were significantly elevated,and were significantly higher than that of control group(P<0.05).Spearman rank correlation analysis was used to analyze the positive correlation between the expression level of NF-elevated B in peripheral blood of the children with viral myocarditis and the level of VMC patients(P<0.05).Conclusion The expression of NF-κB in peripheral blood of children with viral myocarditis is positively correlated with the level of VMC patients,which can be used as an important reference for the determination of the severity of VMC patients.