轮状病毒引起婴幼儿腹泻伴心肌损害的检测分析

目的分析轮状病毒性腹泻患儿心肌受损情况和所伴随生化检验指标改变。方法 2008年7月-2010年7月收治腹泻患儿80例,年龄6～27个月,平均12.9个月。其中有50例为轮状病毒腹泻(A组),30例为非轮状病毒性腹泻(B组)。A组患儿均符合轮状病毒腹泻诊断标准,有心肌损伤的异常指标但达不到心肌炎诊断标准者诊断为心肌损害。B组患儿有水样腹泻,但症状较轻,病程较短,轮状病毒抗原检测阴性。用全自动生化分析仪测定血清谷草转氨酶、乳酸脱氢酶、肌酸磷酸激酶和肌酸磷酸激酶同工酶,免疫亲和层析法测定血清肌钙蛋白值,并进行心电图检查。结果 A组50例轮状病毒性腹泻患儿中,44例(88.0%)存在心肌损害,其血清谷草转氨酶(74.32±13.77)U/L、肌酸磷酸激酶(52.01±10.37)U/L、肌酸磷酸激酶同工酶(273.43±27.55)U/L均升高,且明显高于B组(24.98±7.03)、(17.11±6.52)、(151.46±16.52)U/L],差异有统计学意义(P<0.05)。两组患儿的乳酸脱氢酶变化差异无统计学意义(P>0.05)。结论轮状病毒性腹泻患儿往往伴有心肌损害及相应的血液生化检测指标改变;以肌酸磷酸激酶同工酶作为近期心肌损害的诊断指标更为特异和敏感。

Detection and Analysis of Myocardial Damage Accompanied with Rotavirus-caused Infantile Diarrhea

Objective To analyze myocardial damage in child patients with rotavirus-caused diarrhea and its accompanied biochemical changes.Methods From July 2008 to July 2010,72 children with diarrhea were treated in our hospital,with their age ranged from 6 to 27 months,averaging at 12.9 months.There were 50 cases of rotavirus diarrhea(group A),and 30 cases of the non-rotavirus diarrhea(group B).Children in group A were in line with the rotavirus diarrhea diagnosis standard of myocardial damage,which was abnormal but could not reach the standard of myocarditis.Children in group B had watery diarrhea,but their symptoms were lighter,and their rotavirus antigen detection showed negative.Automatic biochemistry analyzer was used to determine serum levels of aspertate aminotransferase(AST),lactate dehydrogenase(LDH),creatine phosphokinase(CPK),and CPK isozyme.The serum level of troponin was detected with immune affinity chromatography method,and electrocardiography was carried out.Results Of the 50 patients in group A,44(88.0%) had myocardial damage.AST,CPK and CPK isozyme levels in group A (74.32 ± 13.77),(52.01 ± 10.37),(273.43 ± 27.55) U/L] increased obviously,and were significantly higher than those values in group B children (24.98 ± 7.03),(17.11 ± 6.52),(151.46 ± 16.52) U/L](P < 0.05).Two groups of children had no significant difference in LDH level(P > 0.05).Conclusions Rotavirus-caused viral diarrhea is usually accompanied with myocardial damage and the corresponding biochemical index change;In the several biochemical indicators,CPK isozyme is a more specific and sensitive diagnostic index of recent myocardial damage.