重组人干扰素α1b联合无乳糖饮食对小儿轮状病毒感染性肠炎肠黏膜损伤及心肌酶谱的影响

Effect of recombinant human interferon alpha 1b combined with lactose-free diet on intestinal mucosal impairment and myocardial enzymes in pediatric patients with rotavirus infectious enteritis

目的 观察临床应用重组人干扰素α1b联合无乳糖饮食对小儿轮状病毒(RV)感染性肠炎肠黏膜损伤及心肌酶谱的影响。方法 采用前瞻性研究方法,选取2015年10月至2018年2月四川大学华西医院资阳医院收治的轮状病毒感染性肠炎患儿86例,采用随机平行分组法随机分为对照组和观察组,每组各43例。对照组患儿给予重组人工干扰素α1b治疗,观察组患儿给予重组人工干扰素α1b+无乳糖饮食治疗。对比分析两组患儿治疗后临床疗效、心肌酶谱检测指标及血清中晚期糖基化终末产物(AGEs)、内毒素(EXT)以及二胺氧化酶(DAO)水平变化。结果 观察组患儿治疗总有效率明显高于对照组(95. 3%vs. 85. 7%)(P <0. 05);治疗前,两组患儿心肌酶谱检测指标水平比较,差异无统计学意义(P> 0. 05);治疗后,观察组患儿天门冬氨酸氨基转移酶(AST)(33. 43±3. 62 U/L vs. 39. 61±5. 63 U/L)、α-羟丁酸脱氢酶(α-HBDH)(130. 27±32. 46 U/L vs. 167. 07±31. 35 U/L)、乳酸脱氢酶(LDH)(210. 43±19. 91U/L vs. 232. 53±20. 64 U/L)、肌酸激酶同工酶(CK-MB)(15. 74±2. 46 U/L vs. 21. 13±3. 00 U/L)以及肌酸激酶(CK)(110. 51±12. 24 U/L vs. 156. 82±16. 51 U/L)水平,差异具有统计学意义(P <0. 05)。治疗前,两组患儿血清中晚期糖基化终末产物(AGEs)、内毒素(EXT)、二胺氧化酶(DAO)水平比较,差异无统计学意义(P> 0. 05);治疗后,观察组患儿AGEs(165. 43±21. 52 ng/L vs. 243. 64±35. 23 ng/L)、EXT(0. 37±0. 06 EU/ml vs. 0. 77±0. 15 EU/ml)、DAO(0. 62±0. 21 U/L vs. 1. 33±0. 65 U/L)水平明显低于对照组,差异具有统计学意义(P <0. 05)。结论 临床应用重组人干扰素α1b联合无乳糖饮食对小儿RV感染性肠炎进行治疗能对心肌起到明显保护作用,有效改善肠黏膜损伤状态,提高治疗效果。

Objective To observe the effect of clinical application of recombinant human interferonα1b combined with lactose-free diet on intestinal mucosal impairment and myocardial enzymes in pediatric patients with rotavirus(RV)infectious enteritis.Methods A prospective study was conducted in selection of 86 pediatric patients with rotavirus infectious enteritis admitted to Ziyang Hospital of West China Hospital during October 2015 to February 2018.They were randomly divided into control group and observation group by random parallel grouping method.There were 43 cases in each group.Patients in control group received recombinant interferonα1b for treatment,and patients in observation group were treated with recombinant interferonα1b plus lactose-free diet.Acomparative analysis of clinical efficacy,myocardial zymogram detection and changes in levels of AGEs,EXT and DAO in these two groups after treatment.Results The total effective rate of observation group was significantly higher than that(95.3%vs.85.7%)of control group(P<0.05).Before treatment,the levels of myocardial enzymes in these two groups were not significantly different(P>0.05).After treatment,the blood levels of aspartate aminotransferase(AST)(33.43±3.62 vs.39.61±5.63 U/L)andα-hydroxybutyrate dehydrogenase(α-HBDH)were observed in the observation group(130.27±32.46 vs.167.07±31.35 U/L),lactate dehydrogenase(LDH)(210.43±19.91 vs.232.53±20.64 U/L),creatine kinase isoenzyme(CK-MB)(15.74±2.46 vs.21.13±3.00 U/L)and the level of creatine kinase(CK)(110.51±12.24 vs.156.82±16.51 U/L),and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in serum levels of advanced glycation end products(AGEs),endotoxin(EXT),and diamine oxidase(DAO)between these two groups(P>0.05).After treatment,seruym levels of AGEs(165.43±21.52 vs.243.64±35.23 ng/L),EXT(0.37±0.06 vs.0.77±0.15 EU/ml),and DAO(0.62±0.21 vs.1.33±0.65 U/L)were significantly lower in observation group than those in control group,and the difference was statistically significant(P<0.05).Conclusion The clinical application of recombinant human interferonα1b combined with lactose-free diet in treatment of pediatric patients with RV infectious enteritis can significantly protect the myocardium,effectively improve the status of intestinal mucosal impairment and raise the therapeutic effect.