Dynamic variation of creatine kinase MB isoenzymes and diagnostic value of myocardial damage in ;children with rotavirus diarrhea / 国际儿科学杂志

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.