登革热患者心肌酶变化及与其他实验室指标的关系

发布时间：2019-08-06 14:50

【摘要】：目的探讨登革热患者心肌酶包括乳酸脱氢酶(LDH)、α羟丁酸脱氢酶(HBDH)、肌酸激酶(CK)、肌酸激酶同工酶(CKMB)的变化及与其他实验室指标包括凝血酶原(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)、D-二聚体(DDI)、血小板(PLT)及中性粒细胞含量(NEU)的关系。方法对253例登革热住院患者的临床症状、心肌酶(LDH、HBDH、CK、CKMB)以及其他实验室指标(PT、APTT、FIB、TT、DDI、PLT、NEU)进行分析。结果心肌损害患者肌肉酸痛、骨关节痛、皮疹明显;心肌酶中,特异性抗体出现后CK值比出现前有所降低,而LDH、HBDH则升高,CKMB变化不明显;有出血倾向患者心肌酶普遍比无出血患者高;登革热患者心肌酶与其他实验室指标相关性检测中,只有LDH与TT、DDI及HBDH与TT存在极低相关性,相关系数分别为0.426(P0.001)、0.401(P0.001)和0.405(P0.001),其他均不存在直线相关关系。结论部分登革热患者发生心肌损害,值得引起重视,并且发生损害较早,可在出现特异性抗体之前便已发生,有出血倾向患者损害尤为严重,心肌酶与其他实验室指标直线相关关系不明显,有待进一步加大样本观察分析。
[Abstract]:Objective to investigate the changes of myocardial enzymes including lactic dehydrogenase (LDH), 伪 hydroxybutyrate dehydrogenase (HBDH), creatine kinase (CK), creatine kinase isoenzyme (CKMB) in patients with dengue fever and other laboratory indexes including prothrombin (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibronogen (FIB), D-dimer (DDI),. Relationship between platelet (PLT) and neutrophil content (NEU). Methods the clinical symptoms, myocardial enzyme (LDH,HBDH,CK,CKMB) and other laboratory indexes (PT,APTT,FIB,TT,DDI,PLT,NEU) of 253patients with dengue fever were analyzed. Results muscle soreness, osteoarthritis pain and rash were obvious in patients with myocardial damage, the value of CKK in myocardial enzymes decreased after the appearance of specific antibody, but LDH,HBDH increased, CKMB did not change significantly, and myocardial enzymes in patients with bleeding tendency were generally higher than those without bleeding. In the correlation test between myocardial enzyme and other laboratory indexes in patients with dengue fever, only LDH and TT,DDI and HBDH had very low correlation with TT, and the correlation coefficients were 0.426 (P0. 001), 0.401 (P0. 001) and 0.405 (P 0. 001), respectively. there was no linear correlation among the others. Conclusion Myocardial damage in some patients with dengue fever is worth paying attention to, and the damage occurred earlier, which can occur before the emergence of specific antibody, especially in patients with bleeding tendency. The linear correlation between myocardial enzyme and other laboratory indexes is not obvious, which needs to be further observed and analyzed.
【作者单位】：广州医科大学附属第五医院检验科;广州医科大学附属第五医院急诊科;
【分类号】：R512.8;R446.6

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