摘要
目的 为了了解轮状病毒 (RV)腹泻患儿心脏受累的可能性以及与临床表现及病毒血症等相关因素的关系 .方法 检测 RV腹泻患儿 44例血清心型激酶 (CK- MB)、谷草转氨酶 (AST)值 ,并将 CK- MB的变化与相关临床表现等进行多因素分析 ;以反转录 -套式 PCR方法检测 RV腹泻组患儿外周血血清和单个核细胞中的 RV基因组 .结果 RV腹泻患儿 44例中 ,CK- MB异常者 2 5例 (5 7% ) ,其中 2 2例 (5 0 % )为 2 82～ 498nkat· L- 1 ,3例 (7% )为 6 5 0～ 130 0 nkat· L- 1 ;AST异常者 36例 (82 % ) ,其中 2 4例 (5 5 % )为 783～ 146 6nkat· L- 1 ,4例 (9% )为 15 10～ 2 0 75 nkat· L- 1 ,7例 (16 % )为 2 6 33～ 6 80 0 nkat· L- 1 .腹泻、脱水与酶学增高无显著相关 ,发热程度与之密切相关 .检测到病毒血症 4例 ,其中血浆中 1例 ,外周血单个核细胞中 3例 .结论 在 RV腹泻普通人群中也可能出现肠道外感染 ,心脏可能是受损器官之一 .妥善处理腹泻脱水大量补液与潜在心功能低下之间的矛盾是十分必要的 .
AIM To investigate the possibility of myocardial involvement in children with rotavirus (RV) diarrhea and its association with clinical manifestations and viremia resulting from RV infection. METHODS Levels of creatine kinase MB (CK MB) and aminotranferase(AST) in the serum of children with RV diarrhea were measured and multi factor analysis was performed to explore the correlation between changes in CK MB level and the clinical manifestations. The genome of RV from blood serum and mononuclear cells were tested with reverse nest polymerase chain reaction. RESULTS For CK MB, out of the 44 children with RV diarrhea, 25 (57%) were observed abnormal in terms of the serum level. Out of these 25 cases, the values of 22 (accounting for 50% of the total cases) ranged from 282 nkat·L -1 to 498 nkat·L -1 and 3 (accounting for 7% of the total cases) ranged from 650 nkat·L -1 to 1300 nkat·L -1 . For AST, out of the 44 children with RV diarrhea, 36 (82%) were observed abnormal in the terms of the serum level. Out of the 36 cases, the values of 24 (accounting for 55% of the total cases) ranged from 783 nkat·L -1 to 1466 nkat·L -1 , 4 ranged from 1510 nkat·L -1 to 2075 nkat·L -1 and 7(16%) ranged from 2633 nkat·L -1 to 6800 nkat·L -1 . Neither diarrhea nor dehydration was shown to co relate significantly with the variety of CK MB and AST levels, while significant correlation between fever and the changes in CK MB levels was observed. Viremia was found in 4 cases from 44, out of which one was detected in serum and the other 3 ones, in mononuclear cells. CONCLUSION RV may diffuse from intestine to other systems and organs in common children with rotavirus diarrhea and the heart may be one of the organs to be infected. Precautions must be taken against the contradiction between fluid replacement for dehydration and the potential cardiac hypofunction.
出处
《第四军医大学学报》
北大核心
2001年第8期732-734,共3页
Journal of the Fourth Military Medical University
