手足口病患儿心肌酶及心电图改变及其临床意义

Changes of Myocardial Enzymes and Electrocardiogram in Children with Hand, Foot and Mouth Disease and Its Clinical Significance

目的分析手足口病患儿心肌酶谱以及心电图变化情况。方法 2017年2月—2018年5月,于该院收治的手足口病患儿中选取110例为研究对象,将其归为观察组,再选取该院同时期收治的非手足口病患儿50例,将其归为对照组,两组研究对象均行心电图检查与心肌酶谱学检查,对比两组心肌酶谱与心电图变化情况。结果观察组患儿CK-MB、CK、LDH、AST异常率分别为30.00%、52.73%、58.18%、46.36%,均高于对照组的4.00%、12.00%、30.00%、22.00%,组间差异有统计学意义(χ~2=16.325 8、9.625 7、6.254 7、8.625 8,P<0.05);观察组患儿异位心动过速、早搏、传导阻滞、ST-T改变异常率分别为18.18%、24.55%、25.45%、29.09%,均高于对照组的2.00%、4.00%、4.00%、6.00%,组间差异有统计学意义(χ~2=7.562 5、6.265 7、8.625 7、9.625 5,P<0.05)。结论部分手足口病患儿伴随有心肌损害现象出现,心肌酶谱以及心电图变化情况在其诊断中具有一定价值。

Objective To analyze the changes of myocardial enzymes and electrocardiogram in children with hand, foot and mouth disease. Methods From February 2017 to May 2018, 110 children with hand, foot and mouth disease admitted to our hospital were selected as study subjects. They were classified as observation group, and then children with non-hand, foot and mouth disease admitted to our hospital at the same time were selected. 50 cases were classified as control group. Electrocardiogram and myocardial zymography were performed in both groups. The changes of myocardial enzyme spectrum and electrocardiogram were compared between the two groups. Results The abnormal rates of CK-MB, CK, LDH and AST in the observation group were 30.00%, 52.73%, 58.18% and 46.36%, respectively, which were higher than 4.00%, 12.00%, 30.00% and 22.00% of the control group. The differences were statistically significant(χ^2=16.325 8, 9.625 7, 6.254 7, 8.625 8, P<0.05). The abnormal rates of ectopic tachycardia, premature beats, conduction block and ST-T in the observation group were 18.18%, 24.55%, 25.45%, 29.09%, which were higher than 2.00%,4.00%, 4.00%, and 6.00% of the control group, the difference between the groups was statistically significant(χ^2=7.5625, 6.265 7, 8.625 7, 9.625 5, P<0.05). Conclusion Some children with hand, foot and mouth disease are accompanied by myocardial damage. Myocardial zymogram and ECG changes have certain value in the diagnosis.