目的 分析轮状病毒性腹泻患儿心肌受损情况和所伴随生化检验指标改变。 方法 2008年7月－2010年7月收治腹泻患儿80例，年龄6～27个月，平均12.9个月。其中有50例为轮状病毒腹泻（A组），30例为非轮状病毒性腹泻（B组）。A组患儿均符合轮状病毒腹泻诊断标准，有心肌损伤的异常指标但达不到心肌炎诊断标准者诊断为心肌损害。B组患儿有水样腹泻，但症状较轻，病程较短，轮状病毒抗原检测阴性。用全自动生化分析仪测定血清谷草转氨酶、乳酸脱氢酶、肌酸磷酸激酶和肌酸磷酸激酶同工酶，免疫亲和层析法测定血清肌钙蛋白值，并进行心电图检查。 结果 A组50例轮状病毒性腹泻患儿中，44例（88.0%）存在心肌损害，其血清谷草转氨酶（74.32 ± 13.77）U/L、肌酸磷酸激酶（52.01 ± 10.37）U/L、肌酸磷酸激酶同工酶（273.43 ± 27.55）U/L均升高，且明显高于B组[（24.98 ± 7.03）、（17.11 ± 6.52）、（151.46 ± 16.52）U/L]，差异有统计学意义(P＜0.05)。两组患儿的乳酸脱氢酶变化差异无统计学意义(P＞0.05)。 结论 轮状病毒性腹泻患儿往往伴有心肌损害及相应的血液生化检测指标改变；以肌酸磷酸激酶同工酶作为近期心肌损害的诊断指标更为特异和敏感。
Objective To review the recent studies regarding etiology and management of diarrhea after liver transplantation. Methods The current related literatures about the etiology and management of diarrhea after liver transplantation were reviewed. Results There were approximately 10.00% to 35.44% recipients developed diarrhea after liver transplantation. Other symptoms such as severe body fluid and electrolyte loss, discomfort, and increase blood level of immunosuppressive drug can be caused by diarrhea as well. Clostridium difficile, cytomegalovirus, rotavirus infection and immunosuppressant were main etiological factors. It is important to find out the inducement of diarrhea and work out the corresponding management and other supportive care on the basis of the etiology. Conclusion Diarrhea is a common complication of liver transplantation whose etiology is complex. Appropriate approaches may be helpful to decrease the risk of this complication.
ObjectiveTo systematically evaluate the efficacy of probiotics in preventing antibiotic-associated diarrhea (AAD) in aged people. MethodsPubMed, Web of Science, the Cochrane Database of Systematic Reviews, the Cochrane Controlled Trials Register, CNKI, VIP, and WANFANG electronic databases were searched for studies published, and references of included studies and reviews were screened from database inception to April 2014. Only randomized, controlled trials involving patients older than 65 years were included. Furthermore, only the trials which combined antibiotic administration and probiotic therapy for the prevention of AAD and Jadad score >3 were extracted. ResultsA total of eight articles containing 3 680 subjects (1 843 in the probiotic group, 1 837 people in the control group) met the inclusion criteria. Meta-analysis showed that there was no significant difference in the risk of antibiotic-associated diarrhea (AAD) between probiotics and control groups[RR=0.76, 95%CI (0.51, 1.13), P=0.17]. Further subgroup analysis found that compared with the control group, saccharomyces[RR=1.24, 95%CI (0.70, 2.19), P=0.46], lactobacillus[RR=0.59, 95%CI (0.31, 1.13), P=0.11], multi-probiotics combination[RR=0.58, 95%CI (0.24, 1.41), P=0.23] in the probiotics group were not significantly different. ConclusionThere is no evidence to support that probiotics can reduce the risk of AAD among aged people administrated with antibiotics therapy.