轮状病毒性肠炎患儿肝功能、心肌损伤及免疫功能的变化及临床意义

Detection of liver function, myocardial injury and immune function in children with rotavirus enteritis and its clinical significance

目的观察轮状病毒性肠炎患儿肝功能、心肌酶谱及免疫功能的变化情况,并探讨其临床意义。方法选取2016年1月～2017年12月上海交通大学医学院附属第九人民医院儿科收治的轮状病毒性肠炎患儿110例作为病例组,另选取同期我院收治的轮状病毒抗原检测呈阴性的100例肠炎患儿作为对照组,检测并比较两组患儿的肝功能、心肌酶谱及免疫功能指标水平。结果与对照组相比,病例组患儿的谷丙转氨酶ALT水平[(43.12±13.08)U/L vs (22.70±8.02)U/L]和AST水平[(63.52±15.31)U/L vs (23.33±7.10)U/L]均明显升高,差异均有统计学意义(P<0.05);与对照组相比,病例组患儿的肌酸激酶CK水平[(316.98±45.65)U/L vs (111.72±29.83)U/L]、肌酸激酶同工酶CK-MB水平[(86.89±9.45)U/L vs (21.23±8.77)U/L]、乳酸脱氢酶LDH水平[(256.26±35.98)U/L vs (236.80±32.34)U/L]及α-羟丁酸脱氢酶α-HBDH水平[(250.58±47.10)U/L vs (187.60±33.78)U/L]均显著升高,差异均有统计学意义(P<0.05);而与对照组相比,病例组患儿的分化簇CD3^+水平[(58.56±5.48)%vs (65.97±5.46)%]、辅助型T淋巴细胞CD4^+水平[(40.23±7.02)%vs (49.96±8.37)%]、CD4^+/细胞毒T细胞,CD8^+水平[(1.30±0.25)%vs (2.07±0.50)%]均明显低于对照组,CD8^+水平[(30.98±5.25)%vs (24.18±4.38)%]明显高于对照组,差异均有统计学意义(P<0.05)。结论轮状病毒性肠炎患儿可并发心肌损伤以及肝功能和免疫功能异常,应加强相关指标监测以便准确掌握病情。

Objective To investigate the changes of liver function,myocardial enzymes and immune function in children with rotavirus enteritis.Methods One hundred and ten cases of rotavirus enteritis in our hospital from January 2016 to December 2017 were selected as case group,another 100 cases of enteritis children with negative rotavirus antigen in the same period were selected as control group.The liver function,myocardial enzymes and immune function indexes of the two groups were detected.Results Compared with the control group,the levels of ALT((43.12±13.08)U/L vs(22.70±8.02)U/L,P<0.05)and AST((63.52±15.31)U/L vs(23.33±7.10)U/L,P<0.05)in case group were higher than those in control group.Compared with the control group,The levels of CK((316.98±45.65)U/L vs(111.72±29.83)U/L,P<0.05),CK-MB((86.89±9.45)U/L vs(21.23±8.77)U/L,P<0.05),LDH((256.26±35.98)U/L vs(236.80±32.34)U/L,P<0.05)andα-HBDH((250.58±47.10)U/L vs(187.60±33.78)U/L,P<0.05)of the case group were higher than those of the control group,The levels of CD3^+((58.56±5.48)%vs(65.97±5.46)%,P<0.05),CD4^+((40.23±7.02)%vs(49.96±8.37)%,P<0.05)and CD4^+/CD8^+((1.30±0.25)%vs(2.07±0.50)%,P<0.05)in case group were lower than those in control group,and CD8^+level((30.98±5.25)%vs(24.18±4.38)%,P<0.05)was significantly higher than that in control group.Conclusion Children with rotavirus enteritis can be complicated by myocardial injury and abnormal liver function and immune function.Surveillance of relevant indicators should be strengthened so as to accurately grasp the condition.