呼吸衰竭患儿心肌损害相关指标分析

Analysis of myocardial damage related indexes in children with respiratory failure

目的:探讨呼吸衰竭患儿心肌损害相关指标心肌酶与心电图的变化及临床意义。方法:选择因肺炎引起呼吸衰竭患儿126例,其中Ⅰ型呼吸衰竭77例,2型呼吸衰竭49例。另选50例健康儿童作为对照组,分析各组患儿心肌酶指标和心电图变化。结果:与对照组相比,Ⅰ型呼吸衰竭组及Ⅱ型呼吸衰竭组患儿血清天门冬氨酸转氨酶(AST)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBDH)、肌酸激酶(CK)及其同功酶(CK-MB)水平均明显升高(P<0.01),Ⅱ型呼吸衰竭组上述指标明显高于Ⅰ型呼吸衰竭组(P<0.01)。126例呼吸衰竭患儿中心电图异常改变者109例,对照组、Ⅰ型呼吸衰竭组及Ⅱ型呼吸衰竭组心电图异常率比较差异有统计学意义(P<0.01)。结论:呼吸衰竭患儿的心肌酶水平和心电图异常率明显升高,病情越重,心肌酶升高越明显,心电图异常率越高。

Objective To investigate the variations of myocardial damage related myocardial enzyme indexes and electrocardiographic （ECG） in children with respiratory failure and their clinical significance. Method Total 126 children with respiratory failure due to pneumonia were included in this study, of which 77 cases with type 1 respiratory failure and 49 cases with type 2 respiratory failure. For 50 healthy children were designated as the control group. The variations of myocardial enzyme indexes and ECG of children in each group were analyzed. Results Compared with the control group, the levels of serum aspartate aminotransferase （AST） ,lactate dehydrogenase （LDH） , α- hydroxybutyrate dehydrogenase （α- HBDH） ,creatine kinase （CK） and isoenzyme creatine kinase myocardial bound （CK -MB） in type 1 respiratory failure group and type 2 respiratory failure group were significantly higher （P 〈 0. 01 ） , the above indexes in type 2 respiratory failure group were markedly higher than type 1 respiratory failure group （ P 〈 0. 01 ）. There were 109 cases with abnormal changes of ECG among 126 children of respiratory failure, and the difference in abnormal rate of ECG in the control group, type 1 respiratory failure group and type 2 respiratory failure group was significant（ P 〈 0.01 ）. Conclusion The levels of myocardial enzymes and the abnormal rate of ECG in children with respiratory failure are significantly higher. There is a positive correlation between the severity ,the levels of myocardial enzymes and the abnormal rate of ECG.