肺炎支原体肺炎患儿心肌酶CK-MB变化的临床意义

Clinical significance of changes of serum creatine kinase isozyme MB in children with mycoplasma pneumoniae pneumonia

目的探讨小儿肺炎支原体肺炎(mycoplasma pneumonia,MPP)血心肌酶CK-MB变化的临床意义。方法对128例MPP患儿全部行心肌酶谱、心电图和胸片检测,并对其结果进行分析及随访观察。结果128例MPP患儿中,CK-MB升高的34例(26.56%),心电图异常13例(10.16%),胸片显示心胸比率均正常。大部分患儿治疗后复查心肌酶和心电图均恢复正常。结论小儿肺炎支原体肺炎发生心肌损害较常见,由于其主诉表达不清,症状、体征不典型,容易漏诊。对心肌损害的诊断CK-MB较心电图更敏感,故MPP患儿应常规查心肌酶,以便及早诊断,及时给予保护心肌治疗。

Objective To explore the clinical significance of changes of serum creatine kinase isozyme MB （CK-MB） in children with myeoplasma pneumoniae pneumonia （MPP）. Methods Detection of serum myocardial enzymes, electrecardiogram and X-ray examination were performed in all of 128 children with mycoplasma pnemnoniae pneumonia. The results were analyzed and children were followed up. Results The increase of serum CK-MB was found in 34 children （26.56%） ; abnormal electrocardiogram was found in 13 children （10. 16% ） in 128 children. After treatment, serum myocardial enzymes and electrocardiogram in most of children can return to normal. Cardiothoracic ratio was normal during course of disease. Conclusion Myocardial damage is a relative common phenomenon in process of mycoplasma pneumoniae pneumonia. The absence of expression ability, the untypical symptoms and signs in children might lead to a missed diagnosis. The serum CK-MB is more sensitive to the diagnosis of myocardial damage in children than the electrocardiogram. In order to diagnose the disease early, serum myocardial enzymes should be used as a routine test in children with mycoplasma pneumoniae pneumonia. So the timely measures of protecting myocardium could be carried out in those children.