葡萄糖酸锌改善轮状病毒性肠炎症状的剂量探讨

Dosimetry exploration of zinc gluconate in the improvement of rotavirus enteritis symptoms

目的探究不同剂量葡萄糖酸锌改善轮状病毒性肠炎症状的疗效。方法选择就诊的轮状病毒性肠炎患儿87例,按照随机数字表法分成低锌组(n=44)和高锌组(n=43)。低锌组在常规治疗基础上给予葡萄糖酸锌颗粒0.5 mg·kg^(-1)·d^(-1),分2次口服;高锌组剂量:年龄≤6个月给予10 mg·d^(-1),年龄>6个月给予20 mg·d^(-1),分2次口服,均连服7 d。比较2组患儿治疗后的临床疗效,记录2组腹泻、发热、呕吐持续时间及不良反应发生情况,比较2组治疗前后血清淀粉样蛋白A(SAA)、心肌钙蛋白I(cTnI)、降钙素原(PCT)水平、免疫球蛋白及补体变化。结果治疗后,低锌组和高锌组的总有效率分别为93.18%、90.70%,2组比较差异无统计学意义;2组腹泻、发热持续时间比较差异无统计学意义,高锌组的呕吐持续时间长于低锌组(P<0.05);治疗后2组cTnI、SAA和PCT水平均降低(P<0.05),2组间比较差异无统计学意义;治疗后2组补体C3、补体C4、免疫球蛋白A(IgA)和免疫球蛋白G(IgG)水平高于治疗前(P<0.05),2组比较差异无统计学意义;2组均无明显不良反应发生。结论不同剂量葡萄糖酸锌均能改善轮状病毒性肠炎患儿的临床症状,能有效降低cTnI、SAA和PCT水平,改善免疫应答,但大剂量补锌可能会延长呕吐持续时间。

Objective To explore the dosimetry of zinc gluconate in the improvement of rotavirus enteritis symptoms.Methods A total of 87 children with rotavirus enteritis were enrolled and divided into low-zinc group(n=44)and high-zinc group(n=43)according to random number table method.The children in low-zinc group were given 0.5 mg·kg^(-1)·d^(-1) Zinc Gluconate Granules(oral administration for twice)on the basis of routine treatment.In high-zinc group,children≤6 months were given 10 mg·d^(-1) zinc gluconate,while those>6 months were given 20 mg·d^(-1) zinc gluconate(oral administration for twice,7 days in total).The clinical curative effect between the 2 groups was compared after treatment.The duration of diarrhea,fever and vomiting,and the occurrence of adverse effects in both groups were recorded.The changes in the levels of serum amyloid A(SAA),cardiac troponin I(cTnI),procalcitonin(PCT),immunoglobulins and complements before and after treatment between the 2 groups were compared.Results After treatment,the difference in total response rate between low-zinc group and high-zinc group was not statistically significant(93.18%vs.90.70%)(P>0.05).After treatment,the difference in duration of diarrhea and fever between the 2 groups was not statistically significant.However,the duration of vomiting in high-zinc group was longer than that in low-zinc group(P<0.05).After treatment,the levels of cTnI,SAA and PCT in both groups were decreased(P<0.05),but the difference between the 2 groups was not statistically significant(P>0.05).After treatment,the levels of complement 3(C3),complement 4(C4),immunoglobulin A(IgA)and immunoglobulin G(IgG)in both groups were increased(P<0.05),but the difference between the 2 groups was not statistically significant(P>0.05).There was no significant adverse reaction in either group.Conclusion Different doses of zinc gluconate can improve clinical symptoms in children with rotavirus enteritis,effectively reduce the levels of cTnI,SAA and PCT,and improve immune response.However,high-dose zinc supplementation may prolong the duration of vomiting.