腹泻患儿大便轮状病毒检测结果与血清锌及CK-MB水平的关系

Relationship between stool rotavirus test results and serum zinc and CK-MB levels in children with diarrhea

目的研究腹泻患儿大便轮状病毒检测结果与血清锌、肌酸激酶同工酶(CK-MB)水平的关系。方法回顾性选取2018年1月至2019年1月邯郸市妇幼保健院收治的94例腹泻患儿,以轮状病毒检测结果进行分组:轮状病毒腹泻患儿43例纳入感染组,非轮状病毒腹泻患儿51例纳入非感染组。比较两组患儿的血清锌与CK-MB水平,观察感染组患儿脱水程度和血清锌与CK-MB水平的关系,分析腹泻患儿血清锌、CK-MB水平与轮状病毒检测的结果的关系,以及血清锌、CK-MB对腹泻患儿轮状病毒感染的诊断效能。结果感染组患儿的血清锌水平为(63.90±13.08)μmol/L,明显低于非感染组[(82.85±9.21)μmol/L],CK-MB水平为(46.68±9.25)U/L,明显高于非感染组[(46.68±9.25)U/L],差异均有统计学意义(P<0.05)。感染组不同脱水程度患儿的血清锌与CK-MB水平比较,差异均有统计学意义(P<0.05),随着感染组患儿脱水程度越严重,血清锌水平越低,CK-MB水平越高。腹泻患儿血清锌、CK-MB阳性结果与轮状病毒阳性结果的一致性检验Kappa值为0.510、0.513,一致性较高(P<0.05)。腹泻患儿血清锌、CK-MB诊断轮状病毒的敏感度(76.74%vs.81.40%)、特异度(74.51%vs.70.59%)以及诊断符合率(75.53%vs.75.53%)比较,差异均无统计学意义(P>0.05)。结论轮状病毒引起的腹泻患儿血清中的锌水平显著下降,而CK-MB的水平显著升高,变化随着脱水程度加重而改变更明显。检测血清锌与CK-MB水平对诊断轮状病毒感染有较高的参考价值,对预防小儿因病毒感染引发的心肌炎也具有指导意义。

Objective To study the relationship between stool rotavirus detection results and serum zinc and creatine kinase isoenzyme(CK-MB)levels in children with diarrhea.Methods A total of 94 children with diarrhea admitted to Handan Maternal and Child Health Hospital from January 2018 to January 2019 were retrospectively selected and grouped according to the results of rotavirus detection:43 children with rotavirus diarrhea were included in the infection group,and 51 children with non-rotavirus diarrhea were included in the non-infection group.The serum zinc and CK-MB levels of two groups of children were compared,the relationship between dehydration degree and serum zinc and CK-MB levels in infected children were observed,the relationship between serum zinc and CK-MB levels in children with diarrhea and the results of rotavirus detection was analyzed,and the diagnostic efficacy of serum zinc and CK-MB for rotavirus infection in children with diarrhea was evaluated.Results The serum zinc level in the infection group was(63.90±13.08)μmol/L,which was significantly lower than that in the non-infection group[(82.85±9.21)μmol/L],and the CK-MB level was(46.68±9.25)U/L,which was significantly higher than that in the non-infection group[(46.68±9.25)U/L],the differences were statistically significant(P<0.05).There were statistically significant differences in serum zinc and CK-MB levels among children with different degrees of dehydration in the infection group(P<0.05),with the more severe dehydration in the infection group,the lower the serum zinc level,the higher the CK-MB level.The Kappa values of serum zinc,CK-MB positive results and rotavirus positive results in children with diarrhea were 0.510 and 0.513,with high consistency(P<0.05).There were no statistically significant differences in the sensitivity(76.74%vs.81.40%),specificity(74.51%vs.70.59%)and diagnostic coincidence rate(75.53%vs.75.53%)of serum zinc and CK-MB in the diagnosis of rotavirus in children with diarrhea(P>0.05).Conclusion The serum zinc level in children with diarrhea caused by rotavirus decreased significantly,while the concentration of CK-MB increased,which has a high reference value for the diagnosis of rotavirus,and the change is more obvious with the aggravation of dehydration,which also has guiding significance for the prevention of myocarditis caused by viral infection in children.