小儿重症肺炎心肌酶谱的变化研究

Myocardial enzymogram changes in children with severe pneumonia

目的:观察肺炎患儿心肌酶的变化情况,研究低氧血症与心肌酶变化的关系。方法:回顾性分析我院239例肺炎患儿的临床资料,比较普通肺炎组(164例)与重症肺炎组(75例)的心肌酶情况,研究低氧血症与心肌酶相关性。结果:重症肺炎组心肌酶血清水平及异常率均比较高,与普通肺炎组比较差异有统计学意义(P<0.05),重症肺炎组中不同氧分压(PaO2)各组心肌酶血清水平差异均有统计学意义(P<0.05),随PaO2降低,心肌酶出现升高,谷草转氨酶(AST)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBDH)、磷酸肌酸激酶及其同工酶(CK、CK-MB)与PaO2均呈负相关,其中以CK-MB相关系数(r=-0.692)较高。结论:心肌酶谱对重症肺炎的心肌损伤有较好的监测作用。

Objective： To observe the changes of myocardial enzymes in children with pneumonia, and to study relationship between hypoxemia and myocardial enzyme changes. Methods. Clinical data of 239 cases with pneumonia were analyzed retrospectively. Myocardial enzymes of ordinary pneumonia group （164 cases ） and severe pneumonia group （ 75 cases） were detected and compared, and the relationship be- tween hypoxemia and myocardial enzyme was also analyzed. Result： Myocardial enzyme serum levels and abnormal rates of severe pneumonia group were significantly higher （P〈0. 05） compared with ordinary pneumonia; cardiac serum levels at different PaO2 groups were significant different from each other （P〈 0.05）, cardiac enzymes were increased with PaO2 decreased. AST, LDH,α-HBDH in CK, CK-MB and PaO2 were negatively correlated with PaO2. And CK-MB had the highest correlation coefficient （r= - 0. 692）. Gonclusions. Myocardial enzyme is effective index for monitoring myocardial injury status in patients with severe pneumonia.