不同脱水程度轮状病毒肠炎患儿肝、肾、心肌损害临床分析  

Analysis of Rotavirus Enteritis of Children Complicated with Liver,Kindey and Heart Damage

作　　者：张旭光[1] 熊彪[1] 毕金娥[1] 肖政祥[1] 张莉[1] 卢仕仰 朱春婵 

机构地区：[1]广东省深圳市龙岗区妇幼保健院,广东深圳518172

出　　处：《儿科药学杂志》2015年第8期9-11,共3页Journal of Pediatric Pharmacy

基　　金：深圳市龙岗区2012年科技计划项目;项目编号ys2012075

摘　　要：目的:探讨不同脱水程度轮状病毒(RV)肠炎患儿肝、肾、心肌损害情况及心肌酶谱的变化及意义。方法:将297例RV肠炎患儿分为轻度脱水组175例、中度脱水组87例、重度脱水组35例,分别取静脉血采用Olympus 5400全自动生化分析仪检测肝肾功能[天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、尿素氮(BUN)、肌酐(CREA)]和心肌酶谱[AST、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、羟丁酸脱氢酶(HBDH)]指标,同时对中重度脱水患儿进行心电图检查,心电图检查异常者检查超声心动图,并对结果进行分析。结果:轻度脱水组、中度脱水组、重度脱水组肝损害率分别为4.57%、20.69%、48.57%,肾损害率分别为0.00%、1.15%、8.57%,心肌损害率分别为1.14%、4.59%、25.71%。心肌酶谱检查结果显示,重度脱水组和中度脱水组的CK、LDH、HBDH水平比较差异均无统计学意义(P均>0.05),但均高于轻度脱水组(P均<0.05)。122例中重度脱水RV肠炎患儿中28例(22.95%)心电图异常,主要表现为心动过速、ST-T改变和Ⅱ度房室传导阻滞,其中21例检查超声心动图有5例(23.81%)异常。结论:RV肠炎可引起肝、肾、心肌损害且与脱水严重程度呈正相关。动态观察肝、肾功能和心肌酶谱指标,结合心电图和超声心动图检查,对明确诊断、指导治疗有重要的临床意义。Objective： To study the liver, kindey, heart damage and the changes of myocardial enzymes in children with rotavirus enteritis of different dehydration degree. Methods： Serum samples of 297 rotaviral enteritis children who had mild, moderate, severe dehydration were examined for myocardial enzymes, liver and kidney function. Moderate and severe dehydration of rotaviral enteritis children were examined for electrocardiogram and echocardiography, and then the results were compared and analyzed. Results： The incidences of hepatic, kidney and myocardial injury in children with rotavirus enteritis in the mild dehydration group were 4.57% , 0. 00% , l. 14% , in the moderate dehydration group were 20.69% , 1.15% , 4.59% , in the severe dehydration group were 48.57% , 8.57%, 25.71%. The levels of serum creatine kinase （ CK）, lactate dehydrogenase （ LDH）, hydroxybutyric dehydrogenase （HBDH） in children with rotavirus enteritis, the moderate dehydration group and the severe dehydration group were significantly higher than the mild dehydration group （P〈0.05）. There was no significant difference in moderate and severe dehydration group. In the moderate and severe dehydration group, there were 28 cases with anomalous ECG, including tachycardia, ST-T change, Ⅱ degree atrioventricular block. Among the 21 cases of echocardiography examination, there were 5 abnormal cases. Conclusion： Rotavirus enteritis is often associated with liver, kindey, myocardial damage which is proportional to the severity of dehydration in children. Therefore, liver and kidney function, myocardial enzymes, ECG and echocardiography have important significant to diagnose and therapy.

关 键 词：轮状病毒 肠炎 心肌损害 心肌酶谱 心电图 超声心动图 

分 类 号：R725.7[医药卫生—儿科]