消化系统疾病专栏

全血锌与轮状病毒胃肠炎病情严重程度相关性研究

  • 季翠红 ,
  • 俞君 ,
  • 蒋丽蓉
展开
  • 1.上海市奉贤区中心医院(上海 201499)
    2.上海交通大学医学院附属上海儿童医学中心(上海 200127)

收稿日期: 2021-08-30

  网络出版日期: 2022-11-10

基金资助

奉贤区科委社会类科技发展基金项目(20181938)

Correlation between whole blood zinc and severity of rotavirus gastroenteritis

  • Cuihong JI ,
  • Jun YU ,
  • Lirong JIANG
Expand
  • 1. Department of Pediatrics, Central Hospital of Fengxian District, Shanghai 201499, China
    2. Shanghai Children’s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 226001, China

Received date: 2021-08-30

  Online published: 2022-11-10

摘要

目的 探讨全血锌水平与轮状病毒胃肠炎(RVGE)病情严重程度及疗效的相关性。方法 选取2018年10月—2020年12月上海市奉贤区中心医院住院及门急诊就诊的RVGE患儿168例作为RV组,根据全血锌水平分为RV缺锌组100例和RV锌正常组168例,两组再根据是否补锌分为RV缺锌治疗组、RV缺锌对照组、RV锌正常治疗组、RV锌正常对照组,另选择同期来院体检的健康儿童124例作为对照组,各组均采用原子吸收光谱仪检测全血锌水平。结果 RV组全血锌水平为(62.8±10.9)μmol/L,低于对照组[(71.3±7.7)μmol/L],差异有统计学意义(P<0.05)。RVGE患儿轻型组全血锌水平为(66.1±10.6)μmol/L,高于中型组[(61.2±10.9)μmol/L]和重型组[(56.0±5.1)μmol/L],差异有统计学意义(P<0.05)。RV缺锌组与RV锌正常组之间病情严重度分型、脱水比例、大便次数的差异均有统计学意义(P<0.05)。RV缺锌对照组的病程长于RV缺锌治疗组、RV锌正常治疗组和RV锌正常对照组,差异有统计学意义(P<0.05)。结论 RVGE患儿血锌水平明显下降,锌缺乏发生率高于健康儿童,血锌水平与RVGE病情严重程度存在相关性,补锌治疗能缩短锌缺乏RVGE患儿的病程。

本文引用格式

季翠红 , 俞君 , 蒋丽蓉 . 全血锌与轮状病毒胃肠炎病情严重程度相关性研究[J]. 临床儿科杂志, 2022 , 40(11) : 839 -842 . DOI: 10.12372/jcp.2022.21e1253

Abstract

Objective To study the correlation between blood zinc level and severity of rotavirus (RV) gastroenteritis (RVGE) by measuring whole blood zinc level in children with RVGE. Methods One-hundred-and-sixty-eight (168) children with RVGE in Fengxian District Central Hospital of Shanghai from October 2018 to December 2020 were selected as the RV group, and were divided into RV zinc deficiency group and RV normal zinc group, based on their blood zinc levels. The two groups were divided further into RV zinc deficiency treatment group, RV zinc deficiency control group, RV zinc normal treatment group and RV zinc normal control group. There were 124 healthy children who came to the hospital for physical examination in the same period were selected as the healthy control group. The whole blood zinc level of each group was detected by atomic absorption spectrometer. Results The whole blood zinc of RV group (62. 81± 10.92 μmol/L) was significantly lower than that of the healthy control group (71.31±7.74 μmol/L.) The proportion of zinc deficiency in RV group was higher than that in the healthy control group (P<0.05); The whole blood zinc level in the mild group of children with RVGE was (66.1± 10.6 μmol/L), which was higher than that of the moderate group (61.2±10.9 μmol/L) and the severe group (56.0±5.1 μmol/L), with statistically significant differences (P<0.05). The differences in severity of disease typing, proportion of dehydration, and number of stools between the RV zinc deficiency group and the RV zinc normal group were statistically significant (P<0.05). The disease course of the RV zinc deficiency control group was longer than that of the RV zinc deficiency treatment group, the RV zinc normal treatment group and the RV zinc normal control group, the difference was statistically significant (all P<0.05). Conclusion The level of whole blood zinc in children with RVGE decreased significantly, and the incidence of zinc deficiency was higher than that in healthy children. There was a correlation between the level of zinc and the severity of RVGE. Zinc supplementation was effective in the treatment of zinc deficiency children with RVGE..

参考文献

[1] 国家卫生健康委员会,国家中医药管理局. 儿童急性感染性腹泻病诊疗规范(2020年版). [EB/OL]. http://www.nhc.gov.cn/yzygj/s7659/202009/5c03bafd1db74fb68e2a74afa2ed08c1.shtml,2020-09-07/2022-09-20.
[2] WHO/UNICEF Joint Statement. Clinical management of acute diarrhea[R]. Genevai: The United Nations Children’s Fund/World Health Organization, 2004: 1-8.
[3] Lazzerini M, Ronfani L. Oral zinc for treating diarrhoea in children[J]. Cochrane Database Syst Rev, 2016: CD005436.
[4] Guarino A, Ashkenazi S, Gendrel D, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: update 2014[J]. J Pediatr Gastroenterol Nutr, 2014, 59(1): 132-152.
[5] 中华医学会儿科学分会感染学组,中国儿童免疫与健康联盟. 儿童轮状病毒胃肠炎诊疗预防路径[J]. 中国实用儿科杂志, 2021, 36(5): 321-323.
[6] 方鹤松, 魏承毓, 段恕诚, 等. “98全国腹泻病防治学术研讨会”纪要、腹泻病治疗新原则、疗效判断标准的补充建议[J]. 临床儿科杂志, 1998, 16(5): 358.
[7] 蔡眉, 唐振华, 余文. 血锌、铁与血常规检测在儿童感染和贫血时的变化[J]. 检验医学, 2014, 29(11): 1164-1168.
[8] Prasad AS, Bao B. Molecular Mechanisms of zinc as a pro-antioxidant mediator: clinical therapeutic implications[J]. Antioxidants (Basel), 2019, 8(6): 164.
[9] Lassi ZS, Kurji J, Oliveira CS, et al. Zinc supplementation for the promotion of growth and prevention of infections in infants less than six months of age[J]. Cochrane Database Syst Rev, 2020, 4(4): CD010205.
[10] Agarwal, Astha Agarwal A, Gupta NK, et al. Serum zinc levels as a predictor of severity of acute diarrhea[J]. Indian J Pediatr, 2018, 85(3): 179-183.
[11] Desselberger U. Differences of rotavirus vaccine effectiveness by country: likely causes and contributing factors[J]. Pathogens, 2017, 6(4): 65.
[12] Arora R, Kulshreshtha S, Mohan G, et al. Estimation of serum zinc and copper in children with acute diarrhea[J]. Biol Trace Elem Res, 2006, 114: 121-126.
[13] Malik R. The role of zinc in childhood infectious disease[J]. Indian J Pediatr, 2018, 85(3): 166-167.
[14] 叶晓琳, 程双楠, 吴捷. 血清锌与婴幼儿腹泻病的关系研究[J]. 中国小儿急救医学, 2018, 25(3): 1673-4912.
[15] Hoque KM, Rajendran VM, Binder HJ. Zinc inhibits cAMP-stimulated Cl secretion via basolateral K-channel blockade in rat ileum[J]. Am J Physiol Gastrointest Liver Physiol, 2005, 288(5): G956-G963.
[16] Malla L, Perera-Salazar R, Akech S, et al. Examining the effectiveness of zinc treatment in children admitted with diarrhoea in Kenya's public hospitals: an observational comparative effectiveness study[J]. J Glob Health, 2019, 9(2): 020416.
文章导航

/