儿童手足口病心肌酶相关影响因素分析  

Analysis on Related Factors of Myocardial Enzymes in Children with Hand,Foot,and Mouth Disease

作　　者：曾祥英[1] 秦晨光 陈蕾[3] 聂国明 zENG Xiangying;QIN Cheng-uang;CHEN Lei;NIE Guoming(Graduate School,Hubei University,Wuhan Hubei 430062,Chin)

机构地区：[1]湖北大学医院儿科,湖北武汉430062 [2]解放军武汉总医院儿科 [3]南方医科大学研究生院

出　　处：《华南国防医学杂志》2018年第7期446-449,共4页Military Medical Journal of South China

基　　金：湖北省科技厅科技支撑计划(2015BCA273)

摘　　要：目的探讨手足口病患儿心肌酶谱变化规律及心肌酶水平改变的相关影响因素,以期对临床具有指导性的意义。方法选择作者医院在2017-01/2018-01月收治的手足口病患儿60例(肛拭子标本肠道病毒核酸检测确诊为EV71感染型和Cox A16感染型)作为病例组,以年龄、性别相匹配的同期体检健康儿童30例为对照组。所有研究对象均采集血清标本进行心肌酶谱检测,包括谷氨酸氨基转移酶(aspartate aminotransferase,AST)、乳酸脱氢酶(lactate dehydrogenase,LDH)、肌酸激酶(creatine kinase,CK)、肌酸激酶同工酶(creatine kinase isoenzymes,CK-MB)、α-羟丁酸脱氢酶(α-hydroxybutyric acid dehydrogenase,α-HBDH)。采用Pearson相关分析患儿的基线指标、体温变化、感染肠道病毒类型及病情轻重情况及其与心肌酶水平的相关性。结果病例组患儿的5种心肌酶检测结果,均明显高于对照组,组间比较差异均有统计学意义(P<0.05),以CK和CK-MB两种酶变化较为明显;病例组患儿5项指标异常率明显高于对照组,组间比较差异均具有有统计学意义(P<0.01),异常率由高到低依次为LDH(63.33%)、CK-MB(51.66%)、CK(43.33%)、α-HBDH(26.67%)、AST(18.33%)。心肌酶谱影响因素的Pearson相关分析显示:发热程度、病程、病情严重度及所感染病毒类型等与CK-MB的变化密切相关(r分别为0.517、0.961、0.357、0.684,P均<0.05);CK-MB与病例组患儿年龄无统计学相关性(r=0.017,P>0.05)。结论手足口病患儿心肌酶谱水平明显增高,以CK、CK-MB升高最为显著。手足口病患儿的发热程度、病程、病情严重度及所感染病毒类型与CK-MB表达水平密切相关。Objective To investigate the change rule of myocardial enzymes and related influencing factors in children with hand,foot,and m outh disease（ H FM D） in order to guide the clinical significance. M ethods Sixty H FM D children in authors＇ hospital from January 2 0 1 7 to January 2 0 1 8（ enterovirus nucleic acid detection of anal swab sam ples confirm ed EV-A7 1 infection and Cox A1 6 infection） were selected as the case group,m eanwhile,3 0 age and gender-m atched healthy physical exam ination children were collected into control group. Serum sam ples from all subjects were detected by m yocardial enzym e,including aspartate transam inase（ AST）,lactate dehydrogenase（ LDH）,creatine kinase（ CK）,creatine kinase isoenzyme（ CK-MB）,and α-hydroxybutyric acid dehydrogenase（ α-HBDH）. Pearson correlation analysis was used to analyze the correlation of baseline indexes,body temperature changes,enterovirus infection types and severity of illness with m yocardial enzym es levels. Results The testing results of five kinds of m yocardial enzym es in the case group were significantly higher than those in the control group（ P〈0. 0 5）,CK and CK-M B were obviously changed. The abnorm al rate of five indicators in the case group was significantly higher than that in the control group（ P〈0. 0 1）. The lower abnorm al rates of m yocardial enzym es were as follows： LDH（ 6 3. 3 3 %）, CK-M B（ 5 1. 6 6 %）, CK（ 4 3. 3 3 %）, H BDH（ 2 6. 6 7 %） and AST（ 1 8. 3 3 %）.Pearson correlation analysis of the influencing factors of m yocardial enzym es showed that the degree of fever,course of disease,severity of disease and type of infected virus were closely related to the changes of CK-M B（ r = 0. 5 1 7,0. 9 6 1,0. 3 5 7,0. 6 8 4,respectively,all P〈0. 0 5）. No correlation was found between CK-M B and the age of children in the case group（ r = 0. 0 1 7,P〈0. 0 5）. Conclusion The levels of m yocardial enzym es in H FM D children are significantly higher,especially the increa

关 键 词：儿童 手足口病 心肌酶谱 相关分析 

分 类 号：R725.1[医药卫生—儿科]