128例EV71型重症手足口病患儿的心电图与生化指标改变的研究

高连重+李素静+左洁+唐玲

[摘要] 目的 探讨EV71型重症手足口病患儿的心电图与生化指标改变在早期诊疗中的意义。方法 于2015年1月～2016年1月，在我院随机选取128例EV71型重症手足口病患儿为实验组，150例EV71型轻症手足口病患儿为对照组，观察两组患者的生化指标及心电图变化。结果 （1）生化指标：实验组的空腹血糖、白细胞计数及肌酸激酶同工酶（CK-MB）水平均明显高于对照组（P<0.05），而乳酸脱氢酶（LDH）、谷丙转氨酶（ALT）及谷草转氨酶（AST）水平与对照组差异无统计学意义（P>0.05）。（2）心电图：实验组与对照组比较，实验组患儿的心率明显加快，ST-T段异常变化发生率显著增高，差异具有统计学意义（P<0.05），但两组患儿的右束支传导阻滞、室性心动过速、心室纤颤、室性期前收缩发生率差异无统计学意义（P>0.05）。结论 血常规、心肌酶等生化指标变化与心电图变化在重症手足口病患儿的早期诊断中具有重要意义，有较高的临床实践价值。

[关键词] 重症手足口病；心电图；CK-MB；空腹血糖；白细胞计数

[中图分类号] R725.1 [文献标识码] A [文章编号] 2095-0616（2017）20-69-04

Study on changes of electrocardiogram and biochemical indexes of 128 children with EV71 severe hand-foot-and mouth-disease

GAO Lianzhong LI Sujing ZUO Jie TANG Ling

Department of Pediatrics，Ji'nan Central Hospital Affiliated to Shandong University，Ji'nan 250013，China

[Abstract] Objective To investigate the significance of changes of electrocardiogram and biochemical indexes of children with EV71 severe hand-foot-and-mouth disease in early diagnosis and treatment. Methods 128 cases of EV71 severe hand foot and mouth disease were randomly selected as experimental group in our hospital From January 2015 to January 2016，150 children with EV71 mild hand-foot-and-mouth disease were selected as control group.The biochemical indexes and ECG changes of the two groups were observed. Results （1）The biochemical indexes：fasting blood glucose，white blood cell count and creatine kinase isoenzyme （CK-MB） of experimental group were significantly higher than that of the control group（P<0.05），and there was no significant difference in lactate dehydrogenase（LDH），alanine aminotransferase（ALT） and aspartate aminotransferase（AST） levels between the two groups（P>0.05）.（2）The ECG：In the experimental group，the heart rate increased significantly，abnormal ST-T segment change rate increased，the difference was statistically significant（P<0.05），but there was no significant difference of the right bundle branch block，ventricular tachycardia，ventricular fibrillation，ventricular contractions（P>0.05）. Conclusion The changes of biochemical indexes such as blood routine and myocardial enzymes and ECG changes are of great significance in early diagnosis of severe hand-foot-and-mouth disease，and have higher clinical practice value.

[Key words] Severe hand-foot-mouth disease；Electrocardiogram；CK-MB；Fasting blood glucose；White blood count

手足口病是由小核糖核酸腸道病毒引起的急性肠道传染病，而重症手足口病多由感染EV71型肠道病毒引起，以婴幼儿发病为主[1]。近年来我国多个地区出现手足口病的暴发流行，患儿多为轻症手足口病，一般1周内即可痊愈，但少数患儿会发展为重症手足口病[2]。重症手足口病起病急，常并发多种严重并发症，病死率较高，所以如何早期发现并诊断重症手足口病是临床治疗的关键[3]。因此endprint

本研究通过对比分析轻症手足口病患儿和重症手足口病患儿的心电图与生化指标变化，探讨其在重症手足口病患儿早期诊断中的意义。现报道如下。

1 资料与方法

1.1 一般资料

按随机数字表法随机选取2015年1月～2016年1月我院收治的128例EV71型重症手足口病患儿为实验组，150例EV71型轻症手足口病患儿为对照组。……