儿童支原体肺炎行心肌酶谱、心电图检查的临床意义

Implication of the myocardial enzymes and electrocardiogram in children with mycoplasma pneumonia

目的:探讨支原体肺炎患儿心肌酶谱、心电图改变及其临床意义。方法:根据肺炎支原体抗体检查结果分为观测组即支原体肺炎组(Mycoplasma Pneumonia,MP)、对照组即非支原体肺炎组(N-MP)各84例。入院后常规行心肌酶谱检查、十二导联心电图检查。结果:①心肌酶谱5项指标中MP组较N-MP组AST、CK-MB、CK异常概率明显增大,有统计学意义(P<0.01);LDH和α-HBDH无统计学意义(P>0.05)。②心肌酶检测值MP组AST、CK-MB值明显高于N-MP组,有统计学意义(P<0.01);其他三项CK、LDH和α-HBDH差别无统计学意义(P>0.05)。③MP组心肌酶异常与心电图异常情况的关系有统计学意义。结论:心肌酶谱检查是检测肺炎支原体感染引起心肌损伤的重要手段,其中AST、CK-MB是心肌受损的较敏感指标,心电图检查可辅助了解心肌受损情况,指导早期临床治疗。

Objective：To investigate the changes of the myocardial enzymes and the characters of electrocardiogram in children with mycoplasma pneumonia（MP）.Methods：Based on MP antibody assay,84 patients with MP were enrolled into testing group and 84 cases negative for MP were also enrolled as control.Myocardium enzymes（AST、CKMB、CK、LDH and α-HBDH） and electrocardiogram（ECG） were tested immediately after diagnosis.Results：Among the 5 markers of myocardial enzymogram,abnormal serum AST、CK-MB and CK level were detected more frequently in MP group than in N-MP group.The serum level of AST and CK-MB were significantly higher in MP group than in N-MP group.No significant difference of CK、LDH and α-HBDH level were detected between the two groups.Furthermore,we found a statistical correlation between the abnormal myocardium enzymes and ECG abnormal in MP group.Conclusion：Measurement of serum myocardial enzymes is an important method to detect myocardial damage in MP patients.AST and CK-MB are sensitive markers for myocardial damage,as well as ECG,which may be helpful to guide the clinical treatment as soon as possible.