小儿肺炎支原体肺炎心肌酶CK-MB变化的临床意义

Changes of serum myocardial zymogram-creatine Kinase Isozyme B in children with mycoplasma pneumonia pneumonia and its clinical significance

目的:探讨肺炎支原体肺炎(MPP)心肌酶CK-MB变化的临床意义。方法:对205例MPP患儿全部行心肌酶检查,对其中CK-MB升高患儿全部作心电图、心脏彩色多普勒超声和胸片检查,并对结果进行分析及随访观察。结果:205例MPP患儿中,CK-MB值升高62例(30%),其中仅有3例心电图异常,频发室早、Ⅱ导T波低平、夜间Ⅰ度房室传导阻滞各1例。心脏彩色多普勒超声和胸片显示的心胸比率均正常。CK-MB升高者仅有2例(1%)诊断为心肌炎。所有患儿经治疗后心肌酶和心电图均恢复正常。结论:肺炎支原体感染可导致一过性或轻度心肌损伤较常见,但较少导致心肌炎。对心肌损伤的早期诊断,CK-MB较心电图更敏感,故MPP的患儿需常规检查心肌酶。

Objective ：To explore the changes of serum myocardial zymogram - creatine kinase isozyme B （ CK - MB） in children with mycoplasma pneumoniae pneumonia （MPP）and its significance. Methods： In 205 children with MPP,serum myocardial zymogram were measured with Kinetic method by Olympus 5400 autoanalyer,the patients with alnormal levels of serum myocardial CK - MB suffered electrocardiography（ECG） and echocardingram tests. Results： The patients who raised with CK- MB levels were 62 cases （30%）. Only the 3 patients （2. 3% ） with ECG disorders were found,such as ST - T wave changes,multiple ventrieular premature beat and conduction block. Of the 205 MPP patients,only the 2 patients （1%） with raised CK - MB levels could be diagnosed as myocarditis complicated with MPP and the 2 patients could be diagnusecL After using the nutrition myocardium cells with Vit C,the myocardium enzyme and ECG was recovered. Condusion：Mycoplasma pneumoniae （MP）infection can induce myocardial damage. In the early diagnosis of myocardial damage ,higher level of certain myocardial zymogram is more important than ECG. In children with MPP,test of myocardial zymogram is common practice.