婴幼儿轮状病毒肠炎心肌酶谱分析及大剂量VitC疗效观察

目的了解婴幼儿轮状病毒(RV)肠炎并发心肌损伤的几率并探讨大剂量静脉维生素 C(VitC)的治疗作用。方法:测定 76 例急性期 RV 肠炎患儿血清磷酸肌酸激酶心型同功酶(CK鄄M B)和门冬氨酸氨基转移酶(AST),并按脱水程度、有无合并酸中毒、电解质紊乱分组,与正常对照组进行统计学处理。将 CK鄄M B 或 AST 升高的 39 例患儿随机分为常规治疗组和大剂量 VitC 静脉组,观察治疗前后心肌酶谱变化。结果:急性期 RV 肠炎患儿 CK鄄M B、 AST 高于正常对照组(P < 0.05),而腹泻各组之间相比无显著差异(P > 0.05),无脱水组与脱水伴酸中毒或电解质紊乱组相比无显著差异(P > 0.05)。大剂量 VitC 组与常规治疗组治疗前 AST、 CK鄄M B 无显著差异(P > 0.05),治疗后心肌酶谱均有下降,大剂量 VitC 治疗组 AST 的下降比常规治疗组更明显(P < 0.05),治疗后大剂量 VitC 治疗组CK鄄M B 低于常规治疗组,两组之间无显著差异(P > 0.05)。结论:轮状病毒肠炎患儿的心肌酶谱比正常对照组升高,且这种变化在无脱水和酸中毒、电解质紊乱的患儿组中也同样存在,大剂量 VitC 治疗有助于保护心肌。

The observation of the damage of cardiomyocyte and the curative effect of high intravenous dose of vitamin C in infants with rotavirus diarrhoea

Objective: To evaluate the damage of cardiomyocyte that might be involved in infants with rotavirus (RV) diarrhoea and the curative effect of high dose of vitamin C. Methods: We determined AST and CK-MB in 76 infants with RV diarrhoea, and treated 39 of those infants, who showed abnormal myocardial with high dose of vitamin C. Results: AST and CK-MB were increased in infants with RV diarrhoea, whatever lossing fluid and salts in the faeces, and were decreased after being treated with high dose of vitamin C 4~6 days later. Conclusion: We should pay medical attention to myocardial function of infants with RV diarrhea, and high dose of vitamin C can protect cardiomyocytes from damage.