肺炎患儿血清肌酸激酶、肌钙蛋白T水平及ECG检测在疾病治疗及预后评价中的应用研究

Study on application of serum creatine kinase,troponin T levels and ECG detection in treatment and prognosis evaluation of children with pneumonia

目的探讨肺炎患儿血清CK、CTn T水平及ECG检测在疾病治疗及预后评价中的应用价值。方法选取80例肺炎患儿作为观察组,同时选取40例体检健康的儿童作为对照组。分别对两组儿童进行血清CK、CTn T水平及ECG检测。结果治疗前,普通肺炎组的CK-MB水平上升,与对照组比较,差异无统计学意义(P>0.05),CK及CTn T水平显著升高,与对照组比较具有显著差异(P<0.05),65%肺炎患儿心电图异常,主要表现为房性早搏和窦性心动过速;重症肺炎组的CK、CK-MB及CTn T水平均显著上升,与对照组比较,差异有统计学意义(P<0.05),87.5%肺炎患儿心电图异常,主要表现为房性早搏、窦性心动过速、束支传导阻滞和P波高尖等情况。治疗后,普通肺炎组的CK、CK-MB及CTn T水平均明显降低,与对照组比较无显著差异(P>0.05),心电图较多数恢复正常,异常率仅为7.5%;重症肺炎组CK、CK-MB及CTn T水平均明显降低,CK水平与对照组比较,差异无统计学意义(P>0.05),而CK-MB及CTn T水平与对照组比较,差异有统计学意义(P<0.05),心电图也明显恢复,异常率25%,仅窦性心动过速和束支传导阻滞较难恢复。结论肺炎患儿血清CK、CK-MB和CTn T水平随病情加重升高,且ECG异常,通过治疗多数患儿均能治愈。检测肺炎患儿血清CK、CTn T水平及ECG对该疾病治疗及预后评价具有重要意义及参考价值。

[Abstract] Objective To explore the application value of serum creatine kinase （ CK）, cardiac troponin T （CTnT） levels and e- lectrocardiogram （ECG） detection in treatment and prognosis evaluation of children with pneumonia. Methods Eighty children with pneu- monia were selected as observation group, 40 children receiving healthy physical examination during the same period were selected as control group. Serum CK, CTnT levels and ECG detection were performed in the two groups. Results Before treatment, CK-MB level in ordinary pneumonia group increased, compared with control group, there was no statistically significant difference （ P〉0. 05 ） , CK and CTnT levels increased significantly, compared with control group, there was statistically significant difference （P〈0. 05 ）, abnormal ECG was found in 65 % of the children with pneumonia, the main manifestations included atrial premature beats and nodal taehycardia; CK, CK-MB, and CT- nT levels increased significantly in severe pneumonia group, compared with control group, there was statistically significant difference （P〈 0.05 ） , abnormal ECG was found in 87.5% of the children with pneumonia, the main manifestations included atrial premature beats, nodal tachycardia, bundle-branch heart-block, high and sharp P wave. After treatment, CK, CK-MB, and CTnT levels in ordinary pneumonia group decreased significantly, compared with control group, there was no statistically significant difference （ P〉0.05 ）, ECG returned to normal in major children, the abnormal rate was only 7. 5% ; CK, CK-MB, and CTnT levels in severe pneumonia group decreased, there was no statistically significant difference in CK level between severe pneumonia group and control group （ P〉0. 05 ） , but there were statistically significant differences in CK-MB and CTnT levels between severe pneumonia group and control group （ P〈0.05）, ECG returned to normal obviously, the abnormal rate was 25% , only nodal tachycardia and bundle-branch heart-block were hard to restore. Conclusion Serum CK, CK-MB, and CTnT levels increase with aggravation of pneumonia in children with abnormal ECG, most children can be cured after treatment. Serum CK, CTnT levels and ECG detection in children with pneumonia has important significance and reference value for treat- ment and prognosis evaluation of the disease.