深圳市宝安区<5岁婴幼儿急性腹泻病原学及心肌酶及同工酶分析

Etiology and Analysis of Myocardial Enzymes and Isoenzymes in Infants<5 years old with Acute Diarrhea in Bao’an District,Shenzhen

目的:研究分析深圳市宝安区<5岁婴幼儿急性腹泻病原学构成及心肌酶和同工酶的变化,为病毒性腹泻的临床防治提供参考依据。方法:采集2017年1月—2019年12月深圳市宝安区中心医院就诊的1095例<5岁急性腹泻患儿粪便标本及血标本,对其粪便标本进行病原学检测比较分析,并对其血标本进行心肌酶及同工酶检测比较分析。结果:检测的1095例患儿腹泻粪便标本,共四种病毒[轮状病毒(RV)、杯状病毒(HuCV)、腺病毒(AdeV)和星状病毒(AstV)]阴性的占30.14%为阴性组,阳性率占69.86%为阳性组,其中阳性组的RV占35.98%为RV组,HuCV占12.51%为HuCV组,AdeV占4.38%为AdeV组,AstV占2.01%为AstV组,差异有统计学意义(P<0.05);阳性组的肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、谷草转氨酶(AST)和乳酸脱氢酶(LDH)的浓度水平均高于阴性组,差异有统计学意义(P<0.05);RV组、HuCV组、AdeV组与AstV组的CK、CK-MB、AST和LDH的浓度水平均高于阴性组,差异有统计学意义(P<0.05);RV组、HuCV组、AdeV组与AstV组之间的CK、CK-MB、AST和LDH的浓度水平,差异无统计学意义(P>0.05)。结论:RV和HuCV是<5岁急性腹泻患儿主要病原,需要针对性地做好预防控制措施,RV、HuCV、AdeV和AstV病毒性急性腹泻的患儿均伴有不同程度心肌损害,故在治疗时应作心肌酶和同工酶的监测。

Objective:To analyze the etiological composition and changes of myocardial enzymes and isoenzymes of acute diarrhea in infants and young children under 5 years old in Bao’an District,Shenzhen,to provide reference for the clinical prevention and treatment of viral diarrhea.Methods:Fecal and blood samples were collected from 1095 children with acute diarrhea under 5 years old who visited the hospital from January 2017 to December 2019.The fecal samples were compared and analyzed for etiology,and the blood samples were analyzed for myocardial enzymes and isoenzymes.Results:Fecal specimens from 1095 children with diarrhea were tested.The negative rate of four viruses(rotavirus[RV],calicivirus[HuCV],adenovirus[AdeV]and astrovirus[AstV])was 30.14%,which was the negative group.The positive rate accounted for 69.86%,which was the positive group.In the positive group,RV accounting for 35.98%was RV group,HuCV12.51%was HuCV group,AdeV accounted for 4.38%,AdeV group,AstV accounted for 2.01%,AstV group,the difference was statistically significant(P<0.05).The concentrations of creatine kinase(CK),creatine kinase isoenzyme(CK-MB),aspartate aminotransferase(AST)and lactate dehydrogenase(LDH)in the positive group were higher than those in the negative group,and the difference was statistically significant(P<0.05).The concentrations of CK,CK-MB,AST and LDH in the RV group,HuCV group,AdeV group and AstV group were higher than those in the negative group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the concentrations of CK,CK-MB,AST and LDH between the RV group,HuCV group,AdeV group and AstV group(P>0.05).Conclusion:RV and HuCV are the main pathogens in children with acute diarrhea under 5 years old,and targeted preventive and control measures should be taken.Children with RV,HuCV,AdeV and AstV viral acute diarrhea are all accompanied by different degrees of myocardial damage,so myocardial enzymes and isoenzymes should be monitored during treatment.