关键词: H7N9型禽流感病毒, 感染, 生化指标, 心肌标志物

Abstract: Objective To investigate the changes and clinical significance of biochemistry markers in patients with avian influenza A (H7N9) virus infection (2013) before and after treatment. Methods A total of 12 biochemistry markers, including cardiac markers [cardiac troponin T(cTnT), creatine kinase isoenzyme (CK-MB),myoglobin(MYO) and B-type natriuretic peptide(NT-proBNP)],liver function markers [aspartate aminotransferase(AST),alanine aminotransferase(ALT),gamma-glutamyl transpeptidase(GGT),alkaline phosphatase(ALP),total protein(TP) and total bile acid(TBA)] and kidney function markers [creatinine(Cr) and urea nitrogen(BUN)] were determined in 12 cured patients (H7N9 cure group),5 dead patients (H7N9 death group) with avian influenza A (H7N9) virus infection. A total of 50 patients with avian influenza A (H1N1) virus infection (2009) (H1N1 group) and 12 healthy subjects (control group) were enrolled, and the results were analyzed and compared. Results The levels of CK-MB, MYO and NT-proBNP increased in H7N9 cure group and H1N1 group compared with those in control group before the treatment (P<0.05),however,the level of cTnT was normal (P>0.05).The levels of AST, ALT and GGT increased (P<0.05), while those of ALP and TP decreased (P<0.05). The levels of Cr and BUN were normal (P>0.05). Compared with H1N1 group, the increase and decrease degrees for the levels of ALT, ALP, GGT and TP were different, and there was no statistical significance for the other markers (P>0.05). The levels of CK-MB and NT-proBNP in H7N9 death group were higher than those in H7N9 cure group, and the levels of TBA and Cr increased (P<0.05). The levels of CK-MB, MYO, NT-proBNP, AST and TBA decreased after the treatment compared with those before the treatment, and the levels of ALP and TP increased (P<0.05). Compared with the control group, except AST, ALT and GGT, the other markers had no statistical significance in H7N9 cure group after the treatment (P>0.05), and except TP, the other markers had difference in H7N9 death group after the treatment (P<0.05). Conclusions The biochemistry markers may be helpful for the auxiliary diagnosis, progress monitoring and prognosis among the patients with avian influenza A (H7N9) virus infection. The clinical characteristics of biochemistry markers in patients with avian influenza A (H7N9) virus infection are similar with that in patients with avian influenza A (H1N1) virus infection (2009).

Key words: Avian influenza A (H7N9) virus, Infection, Biochemistry marker, Cardiac marker