不同年龄段支原体肺炎合并心肌损害程度的分析

Myocardial damage in mycoplasma pneumonia of children in different age groups

目的探讨肺炎支原体肺炎(mycoplasma pneumoniae pneumonia,MPP)合并心肌损害在婴幼儿年龄上的差别及其临床意义。方法在2011年1月—2012年3月间,对同济大学第十人民医院儿科住院的143名肺炎合并心肌损害的儿童进行统计分析,其中MPIgM(+)70例,MPIgM(-)70例。并按年龄段分组如下:婴儿期(1～12个月):共29例,MgIgM(+)12例,MgIgM(-)17例;幼儿期(13～36个月):共53例,MgIgM(+)26例,M gIgM(-)27例;学龄前期(37月～6岁):共36例,M gIgM(+)20例,M gIgM(-)16例;学龄期(6～12岁):共25例,MgIgM(+)12例,MgIgM(-)13例。结果 MPP患儿血清CK-MB水平高于非MPP患儿(32.5(15.5)μ/L-1 vs 30(7)μ/L-1,Z=2.225,P=0.028);其中13～36个月组(37(17)μ/L-1vs 30(6)μ/L-1,Z=2.226,P=0.02)和6～12岁组(41(21)μ/L-1 vs 30(5)μ/L-1,Z=2.047,P=0.041)这两个年龄段中,MPP所引起的心肌损害程度要比非MPP引起的心肌损害程度严重(P均<0.05)。结论 13～36个月和6～12岁两组年龄段中,MPP引起心肌损害程度严重,提示儿童在不同年龄段对于支原体感染存在不同的免疫应答,应该引起临床高度重视。

Objective To assess the myocardial damage in mycoplasma pneumoniae pneumonia（MPP） of children in different age groups.Methods One hundred and forty three children with pneumonia and myocardial damage admitted between January 2011 and March 2012 were enrolled in the study.The patients were classified as Mycoplasma pneumonia IgM positive（MPIgM＋,n=70） and negative（MPIgM-,n=74）,then further divided into 8 subgroups according to the age： infants（0~12 months） MgIgM＋（n=12）,infant MgIgM-（n=17）;early childhood（13~36 months） MgIgM＋（n=26）,early childhood MgIgM-（n=27）;preschool（37 months-6 years） MgIgM＋（n=20）,preschool MgIgM-（n=16）;school age（6~12 years） MgIgM＋（n=12）,school age MgIgM-（n=13）.The serum creatinine kinase MB isoenzyme（CK-MB） levels were measured as the indicator of myocardial damage.Results The serum CK-MB levels in children with MPP were higher than those in children with nonMPP [32.5（15.5）μ/ L vs 30（7）μ /L,Z=2.225,P=0.028].Children in early childhood and school age had more severe myocardial damage than children with non-MPP in the same age groups Z=2.226,P=0.02 and 41（21）μ/L vs 30（5）μ/L,Z=2.047,P=0.041,respectively].Conclusion Mycoplasma pneumonia infection may cause more serious myocardial damage in children with early childhood and school age.