小儿轮状病毒性肠炎诱发心肌损害相关危害因素研究
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摘要
目的研究分析小儿轮状病毒性肠炎患者诱发心肌损害的危险因素,为预防小儿轮状病毒性肠炎患者发生心肌损害提供可靠依据。方法研究时间:2016年11月—2018年3月;研究对象:方便选取该院收治的80例小儿轮状病毒性肠炎患者。对80例小儿轮状病毒性肠炎患者的临床资料进行回顾性研究分析,根据患者的肌酸激酶同工酶(CK-MB)、肌钙蛋白I(c TnI)、心电图、心脏彩超检查结果,将患者分为心肌损害组、无心肌损害组,比较两组的临床资料,对小儿轮状病毒性肠炎患者发生心肌损害的危险因素进行单因素分析和多因素Logistics线性回归分析。结果 80例小儿轮状病毒性肠炎患者中,共有34例患者发生心肌损害,其余46例患者无心肌损害。单因素分析结果显示,心肌损害组与无心肌损害组在年龄<1岁(12例vs 6例)、呕吐(19例vs 13例)、重度脱水(17例vs 10例)、代谢性酸中毒(19例vs 37例)、血钠水平≥145 mmol/L(9例vs 3例)、血钾水平<3.5mmol/L(11例vs 4例)等方面比较,差异有统计学意义(χ2=5.551、6.215、6.983、5.612、6.102、7.182,P<0.05),而在性别(男/女:18/16 vs 25/21)、病程(≥5 d:10例vs 11例;<5 d:24例vs 35例)等方面比较,差异无统计学意义(χ2=0.016、0.305,P>0.05)。多因素Logistics线性回归分析结果显示,年龄过小、呕吐、脱水程度、代谢性酸中毒、血钠水平过高、血钾水平过低是导致小儿轮状病毒性肠炎患者发生心肌损害的危险因素。结论小儿轮状病毒肠炎患者受到年龄、呕吐、脱水程度、代谢性酸中毒、血钠水平、血钾水平等因素的影响,易发生心肌损害,临床上还需根据其心肌损害相关危险因素实施针对性的预防对策。
Objective To study the risk factors of myocardial damage induced by children with rotavirus enteritis, and to provide a reliable basis for prevention of myocardial damage in children with rotavirus enteritis. Methods Study time:November 2016 to March 2018; Study subjects: 80 children with pediatric rotavirus enteritis admitted were convenient selected to our hospital. A retrospective study was performed on the clinical data of 80 children with rotavirus enteritis. According to the results of creatine kinase isoenzyme(CK-MB), troponin I(cTnI), electrocardiogram, and echocardiography.The patients were divided into myocardial damage group and no myocardial damage group. The clinical data of the two groups were compared. The risk factors of myocardial damage in children with rotavirus enteritis were analyzed by univariate analysis and multivariate logistic linear regression analysis. Results Of the 80 patients with pediatric rotavirus enteritis,34 cases had myocardial damage and the remaining 46 had no myocardial damage. Univariate analysis showed that myocardial damage group and non-myocardial injury group were <1 years old(12 cases vs 6 cases), vomiting(19 cases vs 13 cases), severe dehydration(17 cases vs 10 cases), metabolic acidosis(19 cases vs 37 cases), blood sodium level ≥145 mmol/L(9 cases vs 3 cases), serum potassium level <3.5 mmol/L(11 cases vs 4 cases), the difference was statistically significant(χ2= 5.551, 6.215, 6.983, 5.612, 6.102, 7.182, P<0.05), and in gender(male/female: 18/16 vs 25/21), course of disease(≥5 d:10 cases vs 11 cases; <5 d: 24 case vs. 35 cases), the difference was not statistically significant(χ2=0.016, 0.305, P>0.05).Multivariate logistic regression analysis showed that under-age, vomiting, dehydration, metabolic acidosis, high blood sodium levels, and low potassium levels were risk factors for myocardial damage in children with rotavirus enteritis. Conclusion Children with rotavirus enteritis in children are affected by factors such as age, vomiting, dehydration degree, metabolic acidosis, blood sodium level and blood potassium level, which are prone to myocardial damage. It is also necessary to implement clinical risk factors related to myocardial damage targeted preventive measures.
Objective To study the risk factors of myocardial damage induced by children with rotavirus enteritis, and to provide a reliable basis for prevention of myocardial damage in children with rotavirus enteritis. Methods Study time:November 2016 to March 2018; Study subjects: 80 children with pediatric rotavirus enteritis admitted were convenient selected to our hospital. A retrospective study was performed on the clinical data of 80 children with rotavirus enteritis. According to the results of creatine kinase isoenzyme(CK-MB), troponin I(cTnI), electrocardiogram, and echocardiography.The patients were divided into myocardial damage group and no myocardial damage group. The clinical data of the two groups were compared. The risk factors of myocardial damage in children with rotavirus enteritis were analyzed by univariate analysis and multivariate logistic linear regression analysis. Results Of the 80 patients with pediatric rotavirus enteritis,34 cases had myocardial damage and the remaining 46 had no myocardial damage. Univariate analysis showed that myocardial damage group and non-myocardial injury group were <1 years old(12 cases vs 6 cases), vomiting(19 cases vs 13 cases), severe dehydration(17 cases vs 10 cases), metabolic acidosis(19 cases vs 37 cases), blood sodium level ≥145 mmol/L(9 cases vs 3 cases), serum potassium level <3.5 mmol/L(11 cases vs 4 cases), the difference was statistically significant(χ2= 5.551, 6.215, 6.983, 5.612, 6.102, 7.182, P<0.05), and in gender(male/female: 18/16 vs 25/21), course of disease(≥5 d:10 cases vs 11 cases; <5 d: 24 case vs. 35 cases), the difference was not statistically significant(χ2=0.016, 0.305, P>0.05).Multivariate logistic regression analysis showed that under-age, vomiting, dehydration, metabolic acidosis, high blood sodium levels, and low potassium levels were risk factors for myocardial damage in children with rotavirus enteritis. Conclusion Children with rotavirus enteritis in children are affected by factors such as age, vomiting, dehydration degree, metabolic acidosis, blood sodium level and blood potassium level, which are prone to myocardial damage. It is also necessary to implement clinical risk factors related to myocardial damage targeted preventive measures.
引文
[1]Ianiro G,Delogu R,Baba M,et al.Molecular characteriza tion of group A rotavirus strains detected in children with diarrhea admitted to Nigerian hospitals in 2013[J].Arch Virol,2015,160(6):1511-1517.
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[6]李红梅.磷酸肌酸治疗轮状病毒性肠炎合并心肌损伤的疗效分析[J].世界临床医学,2017,11(2):155-156.
[7]杨兰萍.轮状病毒性肠炎患儿肝功能、心肌酶谱指标的变化及临床意义[J].海南医学院学报,2016,22(23):2883-2885,2889.
[8]Williams D.Treatment of rotavirus-associated diarrhea using enteral immunoglobulins for pediatric stem cell transplant patients[J].J Oncol Pharm Pract,2015,21(3):238-240.
[9]文义.轮状病毒肠炎患儿心肌酶与肝功能指标表达水平及临床意义[J].肝脏,2015,18(6):472-474.
[10]杨彩兰,徐小红,谭梦婷,等.小儿轮状病毒感染导致血清心肌酶CK、CK-MB增高探讨[J].中国现代药物应用,2016,10(15):14-15.
[11]钟旭军.轮状病毒肠炎患儿血清心肌酶水平检测的临床意义[J].中国基层医药,2018,25(10):1256-1258.
[12]吴江华,陈雪娇,甘娜,等.儿童轮状病毒性肠炎诱发心肌损害的影响因素研究[J].河南医学研究,2018,27(2):243-245.
[13]赵素霞.儿童轮状病毒性肠炎合并心肌损害的影响因素分析[J].疾病监测与控制,2017,11(3):221-222.
[14]陈丽洁,张勇,叶飘.小儿轮状病毒肠炎并发心肌损害危险因素分析[J].实用医院临床杂志,2014,11(5):124-125.
[15]吴勇,蔡俊伟,李立浩.婴幼儿轮状病毒肠炎胃肠外损害的危险因素分析[J].中国热带医学,2015,15(12):1496-1498.
[16]孙蕊蕊,刘晓东,栾孟福,等.儿童轮状病毒性肠炎并发心肌损害的影响因素研究[J].中国全科医学,2015,18(4):425-427.
[2]Dong H,Qu S,Chen X,et al.Ch anges in the cytokine expression of peripheral Treg and Th17 cells in children with rotavirus enteritis[J].Exp Ther Med,2015,10(2):679-682.
[3]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,2015,14(8):84-84,87.
[4]Mladenova Z,Nawaz S,Ganesh B,et al.Increased detection of G3P[9]and G6P[9]rotavirus strains in hospitalized children with acute diarrhea in Bulgaria[J].Infect Genet Evol,2015,29(26):118-126.
[5]王学盛.血清心肌酶检测对儿童轮状病毒性肠炎合并心肌损伤的诊断意义[J].中国中西医结合儿科学,2015,7(4):370-371.
[6]李红梅.磷酸肌酸治疗轮状病毒性肠炎合并心肌损伤的疗效分析[J].世界临床医学,2017,11(2):155-156.
[7]杨兰萍.轮状病毒性肠炎患儿肝功能、心肌酶谱指标的变化及临床意义[J].海南医学院学报,2016,22(23):2883-2885,2889.
[8]Williams D.Treatment of rotavirus-associated diarrhea using enteral immunoglobulins for pediatric stem cell transplant patients[J].J Oncol Pharm Pract,2015,21(3):238-240.
[9]文义.轮状病毒肠炎患儿心肌酶与肝功能指标表达水平及临床意义[J].肝脏,2015,18(6):472-474.
[10]杨彩兰,徐小红,谭梦婷,等.小儿轮状病毒感染导致血清心肌酶CK、CK-MB增高探讨[J].中国现代药物应用,2016,10(15):14-15.
[11]钟旭军.轮状病毒肠炎患儿血清心肌酶水平检测的临床意义[J].中国基层医药,2018,25(10):1256-1258.
[12]吴江华,陈雪娇,甘娜,等.儿童轮状病毒性肠炎诱发心肌损害的影响因素研究[J].河南医学研究,2018,27(2):243-245.
[13]赵素霞.儿童轮状病毒性肠炎合并心肌损害的影响因素分析[J].疾病监测与控制,2017,11(3):221-222.
[14]陈丽洁,张勇,叶飘.小儿轮状病毒肠炎并发心肌损害危险因素分析[J].实用医院临床杂志,2014,11(5):124-125.
[15]吴勇,蔡俊伟,李立浩.婴幼儿轮状病毒肠炎胃肠外损害的危险因素分析[J].中国热带医学,2015,15(12):1496-1498.
[16]孙蕊蕊,刘晓东,栾孟福,等.儿童轮状病毒性肠炎并发心肌损害的影响因素研究[J].中国全科医学,2015,18(4):425-427.