小儿支气管肺炎合并心衰的心肌肌钙蛋白Ⅰ表达与预后分析

The cardiac troponin I expression and prognostic analysis in the bronchial pneumonia combined with heart failure in children

目的:探讨小儿支气管肺炎合并心衰的心肌肌钙蛋白Ⅰ表达与预后的相关性。方法:肺炎患儿42例、肺炎伴轻度心衰者38例、肺炎伴中度心衰者28例、肺炎伴重度心衰者12例与正常对照组120例分别进行cTnI检测,观察cTnI表达与预后的相关性。结果:对照组、肺炎组、肺炎轻度、中度、重度心衰组的cTnI值逐渐升高,统计学分析显示5组间cTnI有差异(P<0.01)。患儿经过治疗后,死亡6例,其余都痊愈出院。经过统计分析与受试者工作特征(ROC)曲线分析,cTnI升高与机械通气、入住ICU是患儿死亡的独立预测因素与危险因素。结论:小儿支气管肺炎并发心力衰竭时,随着心力衰竭程度逐渐加重,血清cTnI逐渐升高,并且预后死亡的可能性增加,是小儿院内死亡的独立预测因素。

Objective To investigate the relation of cardiac troponin Ⅰ expression and prognostic in the bronchial pneumonia combined with heart failure in children. Methods 42 children of pneumonia, 38 children of pneumonia combined with mild heart failure, 28 cases of pneumonia combined with moderate heart failure, 12 cases of pneumonia combined with severe heart failure and 120 health children were used the cTnⅠ assay, observed cTnl expression and prognostic relevance. Results The cTnⅠ value were gradually increased in the 5 groups and showed significant differences （P 〈0.01） groups. 6 children were died, the rest were discharged after treatment. After statistical analysis and receiver operating characteristic （ROC） curve analyzed, the cTnl elevation and mechanical ventilation, ICU admission were the risk factors and independent predictors of death in children. Conclusion With heart failure gradually worsened, the serum cTnl were gradually increased in the bronchial pneumonia combined with heart failure children and increases the likelihood of death prognosis, it is the independent predictor of hospital mortality.