ABSTRACT
Objective To investagate the change of creatine kinase MB isoenzymes ( CK-MB ) in children with rotavirus diarrhea and to explore the value of CK-MB/CK in the diagnosis of myocardial damage. Methods A retrospective analysis of the clinical manifestation, laboratory test data and treatment was per-formed in children with rotavirus diarrhea and high CK-MB hospitalized in department of infectious disease, Si-hong Children Hospital. We investigated the dynamic changes of CK-MB in the rotavirus diarrhea patients with and without myocardial damage. Within the non-myocardial damage group, the fluctuation of CK-MB was compared between patients with nutrition therapy and patients with conventional therapy. Receiver operating characteristic ( ROC) curve was used to explore the predictive value of CK-MB/CK for the myocardial dam-age. Results A total of 603 patients (369 males, 234 females, aged 2~48 months) with high CK-MB were enrolled in this study ( 36 cases with myocardial damage ) . There were 54. 6% of enrolled patients showing higher CK-MB and 3. 3% of patients had myocardial damage. The levels of serum CK-MB in non-myocardial damage group reached the peak on day 7 and decreased to normal in 14 days. The levels of serum CK-MB in myocardial damage group reached the peak on day 14 and maintained at fairly high level for 8 weeks and then decreased to normal . Time for CK-MB to achieve peak is different between these two groups. There was no statistical significance in the levels of serum CK-MB on day1 to day 14 between patients with or without myocar-dial protection ( P >0. 05 ) . The ROC curves were constructed with area under the ROC curves of 0. 697 (0. 611, 0. 784, 95%CI). Conclusion Intrinsic dynamics of CK-MB existed in patients with rotavirus diar-rhea. The diagnostic value of CK-MB is limited in patients with myocardial damage.
ABSTRACT
ObjectivesTo study the treatment timing and method of glucocorticoids in the treatment of abdominal type Henoch-Sch?nlein purpura (HSP).MethodsA total of 201 children with abdominal type HSP hospitalized from September 2009 to April 2013 received either conventional glucocorticoids treatment or rapid titration treatment of glucocorticoids based on the same basic therapy. According to the treatment timing and method of glucocorticoids, all patients were divided into 4 groups including early convention group (n=46), late convention group (n=44), early titration group (n=56) and late titration group (n=55). The duration from the appearance of gastrointestinal symptoms to using glucocorticoids less than or equal to three days was deifned as early treatment and more than three days was deifned as late treatment. The patients in two convention groups (early and late) were treated with methylprednisolone (2-6mg/kg per day).The patients in two titration groups (early and late) received rapid titration of methylprednisolone from an initial low dose of 2mg/kg per day to the ifnal target dose. The gastrointestinal symptoms were evaluated every 12 hours. If the gastrointestinal symptoms were not alleviated, an additional dosage of methyl-prednisolone was given. On the next day, the total dose of methylprednisolone in previous 24 hours was used as the initial dose. The dosage was increased in such a way till the gastrointestinal symptoms disappeared and this dosage was remained for 3 days. Then the dosage was gradually reduced to the maintenance dose and stopped. If the gastrointestinal symptoms were relapsed, the patients were treated again. A follow-up of 3-6 months was performed. The dosage, recurrence of symptoms and the side effects were compared among four groups.ResultsThe time of remission, target dose of glucocorticoids, total dose of glucocorticoids, recurrence rate, incidence of severe symptoms and Henoch-Schonlein purpura nephritis were signiifcantly different among four groups (P<0.05). The curative effect was best in early titration group and worst in late convention group.ConclusionsIn the treatment of abdominal type HSP, early titration treatment with glucocorticoids can signiifcantly relieve the gastrointestinal symp-toms and reduce the total dosage of glucocorticoids.
ABSTRACT
Objective To study the dynamic variation of mbisoenzyme of creatine kinase(CK-MB) in the infected course of respiratory syncytial virus and explore the value of CK-MB/CK in the diagnosis of myocardial damage.Methods A total of 577 pediatric patients (317 males,260 females,aged 2 ～ 18 months) with CK-MB/CK ＞5％ from 2010 to 2013 were enrolled in this study (44 complicated by myocardial damage).Five hundred and thirty-three patients with high values CK-MB simply were randomly divided into treatment group (n =243) and control group(n =290).The dynamic variation of CK-MB were investigated.The diagnosis analyzed by receiver operating characteristic (ROC)curve was used to explore the predictive value of differential diagnosis between the pediatric patients with myocardial damage and without myocardial damage.Results Approximately 46.5％ of cases with rotavirus diarrhea had higher CK-MB and 3.5％ of cases had myocardial damage.The time of CK-MB achieved peak and anomalous duration was different between the cases with myocardial damage and without myocardial damage.There was no statistical significance between the cases with or without protecting myocardial(P ＞ 0.05).The ROC curves were constructed with area under the ROC curves of 0.663 (95 ％ CI 0.578,0.747).Conclusion The blood levels of CK-MB in children with respiratory syncytial virus infection existed obvious dynamic variety,which contributed little value to the diagnosis of myocardial damage.