小儿重度感染性脑损伤与心肌酶谱相关性分析

Analysis of the Correlation with Myocardial Enzymes and Severe Infectious brain Injury in Children

目的探讨小儿感染引起重度脑损伤后心肌酶谱改变与格拉斯哥昏迷(GCS)评分及预后的关系,指导临床治疗和护理。方法对30例符合重度脑损伤诊断标准的患儿,于入院当天抽血化验心肌酶谱,包括天冬氨酸转氨酶(aspartate aminotransferase,AST)、乳酸脱氢酶(lactatedehydrogenase,LDH)、α-羟丁酸脱氢酶(α-hydroxybutyrate dehydrogenase,α-HBDH)、肌酸磷酸激酶(creatine phosphokinase,CPK)、心肌型肌酸激酶同功酶(MB isoenzyme of creatine kinase,CKMB)。结果患儿GCS评分3～5分组的19例患者的心肌酶浓度明显高于11例GCS评分6～8分患者(P<0.05)。治愈组11例,留有后遗症组14例,死亡组5例,三组间心肌酶浓度差异显著,死亡组的浓度最高,治愈组的浓度最低(P<0.05)。结论小儿重度感染性脑损伤GCS评分越低,心肌酶谱值越高,预后越差。

Objective To explore the relationship among myocardial enzymes changes,the Glasgow coma scale（GCS） and the prognosis in the severe infectious brain damage in children,so that to guide the clinical treatment and care.Methods According to the diagnostic criteria,30 children of severe brain damage were enrolled.Blood tests of myocardial enzymes were done on the admission day,including aspartate aminotransferase（AST）,lactate dehydrogenase（LDH）,α-hydroxybutyric dehydrogenase（α-HBDH）,creatine kinase（CPK）,MB creatine kinase isoenzyme（CKMB）.Results The myocardial enzymes levels of 19 cases with GCS score of 3 to 5 were significantly higher than those of 11 cases whose GCS score was 6 to 8（P0.05）.11 patients cured,14 cases had sequelae and the other 5 cases died.The myocardial enzyme concentrations were significantly different among the three groups,with the highest concentration in the death group and the lowest group in the cure group（P0.05）.Conclusion It shows significantly influence of the myocardial enzymes in severe infectious brain lesion in children.The lower the GCS is,the higher the myocardial enzymes will be,and the worse the prognosis will be.