重症肺炎患儿心肌损害58例临床分析

Retrospective study of myocardial damage in children with severe pneumonia

目的:观察重症肺炎患儿心肌损害血气指标、心肌酶学的变化。方法:分析58例重症肺炎患儿的心电图、血气指标及心肌酶学的变化并探讨其相关性。结果:心肌酶学异常组的血气分析水平均较心肌酶学正常组有显著改变(P<0.01)。心肌酶学异常组32例中肌酸激酶同工酶水平与血气分析结果的-BE值呈正相关关系(P<0.01)。58例重症肺炎患儿中心电图显著改变者51例,其中心肌酶学异常组患儿32例(62.75%),合并心力衰竭11例(18.97%)。结论:低氧血症、代谢性酸中毒参与了重症肺炎患儿心肌损害的发生、发展,早期改善低氧血症,纠正代谢性酸中毒有利于预防心力衰竭的发生;血气分析、心肌酶学检测及心电图检查有利于早期诊断重症肺炎患儿心肌损害和判断病情预后。

Objective：To observe the changes of blood gas level and myocardial enzymology in children with severe pneumonia. Methods：The changes of the electrocardiogram, blood gas level and myocardial enzymology in 58 children with severe pneumonia were analyzed retrospectively; and the correlations among them were studied. Results： The level of blood gas analysis in the group with abnormal myocardial enzymology was obviously higher than that with normal myocardial enzymology（ P 〈 0.01 ） ; There was a positive correlation between the level of blood gas analysis （ -BE ） and myocardial enzymology （ CK-MB ） in the 32 cases with abnormal myocardial enzymology （ P 〈 0.01 ）. Among the 58 cases of severe pneumonia, 51 presented great changes in electrocardiogram, 32 of whom were in the group with abnormal myocardial enzymology（62.75% ） ; 11 cases were accompanied by heart failure（ 18.97% ）. Conclusions ： Hypoxemia and metabolic acidosis facilitate the genesis and development of myocardial damage. Early intervention could prevent the incidence of heart failure. Blood gas analysis, myocardial enzymology detection and electrocardiogram examination are beneficial to the early diagnosis and prognosis of myocardial damage in children with severe pneumonia.