不同病程甲型H1N1流感患者血清CK、CK-MB、AST、LDH水平变化及临床意义
|
摘要
目的探讨不同病程甲型H1N1流感患者血清肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、谷草转氨酶(AST)、乳酸脱氢酶(LDH)水平变化及临床意义。方法选取2017年1月—2018年12月甲型H1N1流感患者155例作为观察组,按病情程度分危重症(n=43)、重症(n=72)、轻症(n=40),另选同期健康体检者91例作为对照组。均检测血清CK、CK-MB、AST、LDH水平,对比不同分组间上述血清水平变化,探讨其临床意义。结果观察组血清CK、CK-MB、AST、LDH水平较对照组高(P <0. 05);经单因素方差分析,不同分组间血清CK、CK-MB、AST、LDH水平对比,差异有统计学意义(P <0. 05);两两比较,危重症患者高于重症患者,重症患者高于轻症患者(P <0. 05);发病初期血清CK、CK-MB、AST、LDH水平高于稳定期(P <0. 05);经Spearman分析,血清CK、CK-MB、AST、LDH水平与病情严重程度间呈正相关(P <0. 05)。结论血清CK、CK-MB、AST、LDH水平与甲型H1N1流感关系密切,可通过检测上述因子水平及时诊断、评估病情,为临床对症治疗及预后评估提供数据支持。
Objective To investigate the changes of serum creatine kinase( CK),creatine kinase isoenzyme( CK-MB),aspartate aminotransferase( AST) and lactate dehydrogenase( LDH) levels in patients with influenza A( H1 N1) influenza and their clinical significance. Methods From January 2017 to December 2018,155 patients with H1 N1 influenza in our hospital were selected as observation group. According to the severity of the disease,critical illness( n =43),severe disease( n = 72),and mild( n = 40). 91 cases of healthy physical examination in the same period were selected as the control group. The levels of serum CK,CK-MB,AST and LDH were measured,and the changes of serum levels among different groups were compared to explore its clinical significance. Results The levels of serum CK,CK-MB,AST and LDH in the observation group were higher than those in the control group( P < 0. 05). The scores of serum CK,CK-MB,AST and LDH in different groups were statistically significant by one-way analysis of variance.( P < 0. 05); two-two comparison,critically ill patients were higher than severe patients,severe patients were higher than mild patients( P <0. 05); serum CK,CK-MB,AST,LDH levels were higher than stable phase at the early stage of onset( P < 0. 05); After Spearman analysis,serum CK,CK-MB,AST,LDH levels were positively correlated with severity( P < 0. 05). Conclusion The levels of serum CK,CK-MB,AST and LDH are closely related to influenza A( H1 N1). The level of the above factors can be used to diagnose and evaluate the condition in time,and provide data support for clinical symptomatic treatment and prognosis evaluation.
Objective To investigate the changes of serum creatine kinase( CK),creatine kinase isoenzyme( CK-MB),aspartate aminotransferase( AST) and lactate dehydrogenase( LDH) levels in patients with influenza A( H1 N1) influenza and their clinical significance. Methods From January 2017 to December 2018,155 patients with H1 N1 influenza in our hospital were selected as observation group. According to the severity of the disease,critical illness( n =43),severe disease( n = 72),and mild( n = 40). 91 cases of healthy physical examination in the same period were selected as the control group. The levels of serum CK,CK-MB,AST and LDH were measured,and the changes of serum levels among different groups were compared to explore its clinical significance. Results The levels of serum CK,CK-MB,AST and LDH in the observation group were higher than those in the control group( P < 0. 05). The scores of serum CK,CK-MB,AST and LDH in different groups were statistically significant by one-way analysis of variance.( P < 0. 05); two-two comparison,critically ill patients were higher than severe patients,severe patients were higher than mild patients( P <0. 05); serum CK,CK-MB,AST,LDH levels were higher than stable phase at the early stage of onset( P < 0. 05); After Spearman analysis,serum CK,CK-MB,AST,LDH levels were positively correlated with severity( P < 0. 05). Conclusion The levels of serum CK,CK-MB,AST and LDH are closely related to influenza A( H1 N1). The level of the above factors can be used to diagnose and evaluate the condition in time,and provide data support for clinical symptomatic treatment and prognosis evaluation.
引文
[1]车飞虎,崔大伟,孙海燕,等.2013-2015年浙江地区新型甲型H1N1流行性感冒的流行病学和临床特征调查[J].临床检验杂志,2016,34(4):307-311.
[2]李岩,韩光跃,刘艳芳,等.石家庄地区2014-2016年甲型H1N1流感病原学及血清学监测分析[J].中国病毒病杂志,2017,7(4):277-282.
[3]方斌,刘琳琳,李翔,等.湖北省大流行期和流行后期新甲型H1N1流感病毒基因特性分析[J].中华疾病控制杂志,2017,21(1):13-18.
[4]HATANO B,GOTO M,FUKUMOTO H,et al.Mobile and accurate detection system for infection by the 2009 pandemic influenza A(H1N1)virus with a pocket-warmer reverse-transcriptase loop-mediated isothermal amplification[J].J Med Virol,2011,83(4):568-573.
[5]宋文君,曹巧玲.轮状病毒感染性脓毒症患儿血清CRP、免疫球蛋白水平变化及其与心肌酶谱的相关性研究[J].海南医学,2015,26(7):958-960.
[6]张学军,张庆,邢志俐,等.甲型H1N1流感患者血清心肌酶学的临床研究[J].国际呼吸杂志,2012,32(14):1045-1047.
[7]MUGOSA B,VUJOSEVIC D,CICCOZZI M,et al.Genetic diversity of the haemagglutinin(HA)of human influenza A(H1N1)virus in Montenegro:Focus on its origin and evolution[J].J Med Virol,2016,88(11):1905-1913.
[8]陈素萍,杜宝静,滑丽芳,等.腹泻患儿大便细菌培养及轮状病毒检测结果与血清锌、肌酸激酶同工酶的关系[J].检验医学与临床,2018,15(12):1853-1855.
[9]邱燕玲,康淑红,王宝西.赖氨葡锌颗粒联合西咪替丁对轮状病毒肠炎患儿血清肌酸激酶同工酶、天冬氨酸氨基转移酶、白细胞介素6水平变化及预后的影响[J].中国医师进修杂志,2017,40(10):865.
[10]刘廷,王海丹,狄留庆,等.基于甲型H1N1流感病毒致MD-CK细胞损伤保护作用的双黄连组方HPLC特征图谱谱效关系研究[J].中国中药杂志,2015,40(21):4194-4199.
[11]孙晓风,买买提艾力·吾布力,刘浩,等.新疆甲型H1N1流行性感冒住院患者临床特征及并发心肌损害分析[J].中华传染病杂志,2011,29(6):357-360.
[12]林良勇,曾莉.心肌酶谱检测在小儿轮状病毒性肠炎中的应用价值[J].现代医院,2015,15(08):84-87.
[13]刘萌萌,李彦文,周庆彪,等.氯气吸入致大鼠肺血管内皮细胞的线粒体损伤及红景天苷的干预作用[J].癌变·畸变·突变,2018,30(1):31-36.
[14]郑肖瑾,程小珍,贾雁平.果糖二磷酸钠对缺氧缺血新生大鼠心肌损伤的保护作用及机制探讨[J].中国临床药理学杂志,2018,34(15):1851-1853.
[15]王珏,戴洁,王大业,等.新型甲型H1N1流感重症病例肝脏病理学变化分析[J].首都医科大学学报,2015,36(3):437-440.
[16]郑绍同,王书中,杨士军,等.慢性乙型病毒性肝炎患者血清IL-33和s ST2表达水平及临床诊治意义[J].中国中西医结合消化杂志,2017,25(9):666-670.
[2]李岩,韩光跃,刘艳芳,等.石家庄地区2014-2016年甲型H1N1流感病原学及血清学监测分析[J].中国病毒病杂志,2017,7(4):277-282.
[3]方斌,刘琳琳,李翔,等.湖北省大流行期和流行后期新甲型H1N1流感病毒基因特性分析[J].中华疾病控制杂志,2017,21(1):13-18.
[4]HATANO B,GOTO M,FUKUMOTO H,et al.Mobile and accurate detection system for infection by the 2009 pandemic influenza A(H1N1)virus with a pocket-warmer reverse-transcriptase loop-mediated isothermal amplification[J].J Med Virol,2011,83(4):568-573.
[5]宋文君,曹巧玲.轮状病毒感染性脓毒症患儿血清CRP、免疫球蛋白水平变化及其与心肌酶谱的相关性研究[J].海南医学,2015,26(7):958-960.
[6]张学军,张庆,邢志俐,等.甲型H1N1流感患者血清心肌酶学的临床研究[J].国际呼吸杂志,2012,32(14):1045-1047.
[7]MUGOSA B,VUJOSEVIC D,CICCOZZI M,et al.Genetic diversity of the haemagglutinin(HA)of human influenza A(H1N1)virus in Montenegro:Focus on its origin and evolution[J].J Med Virol,2016,88(11):1905-1913.
[8]陈素萍,杜宝静,滑丽芳,等.腹泻患儿大便细菌培养及轮状病毒检测结果与血清锌、肌酸激酶同工酶的关系[J].检验医学与临床,2018,15(12):1853-1855.
[9]邱燕玲,康淑红,王宝西.赖氨葡锌颗粒联合西咪替丁对轮状病毒肠炎患儿血清肌酸激酶同工酶、天冬氨酸氨基转移酶、白细胞介素6水平变化及预后的影响[J].中国医师进修杂志,2017,40(10):865.
[10]刘廷,王海丹,狄留庆,等.基于甲型H1N1流感病毒致MD-CK细胞损伤保护作用的双黄连组方HPLC特征图谱谱效关系研究[J].中国中药杂志,2015,40(21):4194-4199.
[11]孙晓风,买买提艾力·吾布力,刘浩,等.新疆甲型H1N1流行性感冒住院患者临床特征及并发心肌损害分析[J].中华传染病杂志,2011,29(6):357-360.
[12]林良勇,曾莉.心肌酶谱检测在小儿轮状病毒性肠炎中的应用价值[J].现代医院,2015,15(08):84-87.
[13]刘萌萌,李彦文,周庆彪,等.氯气吸入致大鼠肺血管内皮细胞的线粒体损伤及红景天苷的干预作用[J].癌变·畸变·突变,2018,30(1):31-36.
[14]郑肖瑾,程小珍,贾雁平.果糖二磷酸钠对缺氧缺血新生大鼠心肌损伤的保护作用及机制探讨[J].中国临床药理学杂志,2018,34(15):1851-1853.
[15]王珏,戴洁,王大业,等.新型甲型H1N1流感重症病例肝脏病理学变化分析[J].首都医科大学学报,2015,36(3):437-440.
[16]郑绍同,王书中,杨士军,等.慢性乙型病毒性肝炎患者血清IL-33和s ST2表达水平及临床诊治意义[J].中国中西医结合消化杂志,2017,25(9):666-670.