小儿轮状病毒肠炎肠道外脏器损伤及免疫状态研究

Objective To evaluate the parenteral complications and their risk factors and to study the immune status by detecting immunoglobulin and lymphocyte subsets in children with rotavirus enteritis. Methods Sixty-four children with rotavirus enteritis who were treated in Shengjing Hospital of China Medical University between January 2007 and December 2008(observation group) and 18 healthy chiIdren for health screening at pediatric health care center (normal control group) were reeruimd.Clinical manifestations were collected,stool specimens were detected for rotavirus using ELISA,lymphocyte subsets were detected using flow cytometer,and immunoglobulin.liver enzyme and myocardial enzyme were detected.Results Rotavirus enteritis may be complicated by parenteral complications(liver,myocardium,respiratory and nervous system).The activity of ALT,AST,LDH,CK and CK-mB were higher in observation group than that in normal control group(P<0.05).In observation group,liver injury rate in children younger than 12 months was higher than that in children older than 12 months,and the activity of CK and CK-mB were highcr in severe diarrhea casesCK(324.5±995.5)U／dl,CK-mB(93.8 4±61.5)U／dl]than that in mild diarrhea cases CK(252.8±130.4)U／dl,CK.mB(59.6±32.6)U／dl](P<0.05).The level of IgG was lower in observation group(4.46±1.56)g／L]than that in control group(5.80±1.67)g／L](P<0.05).Lymphocytes subsets study revealed that the activity of CD4+ in observation group(29.0±4.18)％]was lower than that in control group(38.6±3.97)％](P<0.05),the activity of CDl9+ (38.8±3.94)％]was higher than that in control group(23.1±7.70)％](P<0.05)and the CD4+／CD8+ ratio was reverse in observafion group.Conclusion Rotavirus enteritis may be complicated by parenteral injuries which get liver,myocardium,respiratory and nervous system involved.Children with rotavirus enteritis Call lead to low immune function.Determination of liver enzyme,myocardial enzyme,immunoglobulin and lymphocyte subsets has important clinical significance to monitoring the change of condition and guiding treatment.

Parenteral organ injury and Immune status in children with rotavirus enteritis