血清肌钙蛋白T及心肌酶在预测轮状病毒性肠炎患儿心肌损伤的应用  

Serum Troponin T and Cardiac Enzymes in Predicting Myocardial Injury in Children with Rotavirus Enteritis

作　　者：胡瑛 肖小兵 黄鹏 Hu Ying;Xiao Xiaobing;Huang Peng(Yuebei People’s Hospital,Shantou University Medical College,Shaoguan,Guangdong,512025,China)

机构地区：[1]汕头大学医学院附属粤北人民医院,广东韶关512025

出　　处：《黑龙江医学》2023年第22期2716-2719,2723,共5页Heilongjiang Medical Journal

基　　金：韶关市卫生健康科研项目(Y21059)。

摘　　要：目的:探究血清肌钙蛋白T(cTnT)及心肌酶在预测轮状病毒性肠炎患儿心肌损伤的应用价值。方法:选取2021年1月—2022年6月汕头大学医学院附属粤北人民医院儿科确诊为轮状病毒性肠炎患儿120例,作为实验组;另选同期住院治疗且轮状病毒抗原检测为阴性的患儿120例,作为对照组。入院当日收集粪便检测轮状病毒,次日抽取晨起空腹状态下肘静脉血样离心取上层血清检测血清cTnT及心肌酶指标α-羟丁酸脱氢酶(α-HBDH)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、天门冬氨酸氨基转移酶(AST)。结果:治疗前,实验组患者血清cTnT及心肌酶指标α-HBDH、CK-MB、LDH、CK、AST水平均高于对照组,差异有统计学意义(t=220.153、9.737、23.620、21.201、30.003、18.072,P<0.05);实验组的中度及重度脱水组与中度及重度酸中毒组患儿血清cTnT及心肌酶指标α-HBDH、CK-MB、LDH、CK、AST水平均高于无脱水及轻度脱水组与无酸中毒及轻度酸中毒组,差异有统计学意义(t=165.560、6.541、15.080、9.998、13.637、10.344,P<0.05);实验组指标异常患儿治疗后,血清cTnT及心肌酶指标α-HBDH、CK-MB、LDH、CK、AST水平均低于治疗前,差异有统计学意义(t=1608.386、11.817、21.816、4.496、42.542、15.903,P<0.05);中度及重度脱水组患儿心肌损伤发生率33.96%高于无脱水及轻度脱水组11.94%,差异有统计学意义(χ^(2)=13.170,P<0.05)。结论:小儿患轮状病毒性肠炎后会导致血清cTnT及心肌酶指标异常升高,导致心肌损伤,且与患儿酸中毒程度及脱水程度密切相关,脱水程度及酸中毒程度加重会增加心肌损伤风险,因而实验室检查血清cTnT及心肌酶指标可早期预测轮状病毒性肠炎患儿的心肌损伤,利于儿科临床早期治疗。Objective:To investigate the value of serum troponin T(cTnT)and cardiac enzymes in predicting myocardial injury in children with rotavirus enteritis.Methods:120 cases of children diagnosed with rotavirus enteritis in the hospital from January 2021 to June 2022 were selected as the experimental group,and another 120 cases of children who were hospitalized in the same period and tested negative for rotavirus antigen were selected as the control group.On the day of admission,feces were collected for rotavirus testing,and on the following day,blood samples from the elbow vein in the morning fasting state were centrifuged to obtain the upper layer of serum for testing serum cTnT and cardiac enzymesα-hydroxybutyric acid dehydrogenase(α-HBDH),creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH),creatine kinase(CK),and aspartate aminotransferase(AST).Results:The levels of serum cTnT and cardiac enzyme indexesα-HBDH,CK-MB,LDH,CK,and AST were higher in the experimental group than in the control group before treatment,and the difference was statistically significant(t=220.153,9.737,23.620,21.201,30.003,18.072,P<0.05).The serum cTnT and cardiac enzyme indexesα-HBDH,CK-MB,LDH,CK,and AST levels of the children in the experimental group were higher than those of the group with no and mild dehydration and the group with no and mild acidosis,and the difference was statistically significant(t=16.560,6.541,15.080,9.998,13.637,10.344,P<0.05).The levels of serum cTnT and cardiac enzyme indexesα-HBDH,CK-MB,LDH,CK,and AST were lower than those before treatment in the experimental group of children with index abnormalities,and the difference was statistically significant(t=1608.386,11.817,21.816,4.496,42.542,15.903,P<0.05).The incidence of myocardial injury in children in the moderate and severe dehydration group was 33.96%,which was higher than that of 11.94%in the non-dehydrated and mildly dehydrated group,and the difference was statistically significant(χ^(2)=13.170,P<0.05).Conclusion:Rotavirus enteritis in children can

关 键 词：血清肌钙蛋白T 心肌酶 轮状病毒性肠炎 心肌损伤 预测价值 

分 类 号：R542.21[医药卫生—心血管疾病]