支原体肺炎患儿心律失常和甲状腺激素水平的相关分析

Analysis on the correlation between children mycoplasma pneumonia complicated with arrhythmia and thyroid hormone levels

目的研究小儿支原体肺炎伴心律失常和甲状腺激素水平的相关性。方法连续选择60例小儿支原体肺炎伴心律失常(病程>3个月),平均随访约2年,比较左室舒张末内径(LVEDd)、左室射血分数(LVEF)、恶性心律失常事件发生率、T淋巴细胞免疫状态和甲状腺激素水平(FT3、FT4、TSH、TGAb和TPOAb)。结果 60例患儿中共出现恶性心律失常事件18例(30.0%)作为观察组,SDNN比对照组减小,LVEDd增加、LVEF降低,CD_4^+T细胞百分比降低、CD_8^+T细胞百分比升高、CD_4^+/CD_8^+降低,差异均有统计学意义(P<0.05)。FT3和FT4比对照组明显降低,TSH、TGAb和TPOAb明显升高,差异有统计学意义(P<0.05)。结论甲状腺激素和抗体水平异常对预测小儿支原体肺炎伴心律失常发生恶性心律失常有一定的指导意义。

Objective To study the correlation between children mycoplasma pneumonia complicated with arrhythmia and thyroid hormone levels. Methods A total of 60 children with mycoplasma pneumoniae and arrhythmia,whose disease course was longer than 3 months,were selected. Their left ventricular end diastolic diameter（ LVEDd） and left ventricular ejection fraction（ LVEF）,incidence of malignant arrhythmic events,T lymphocyte immune status and thyroid hormone levels including FT3,FT4,TSH,TGAb and TPOAb were compared during 2 years follow-up. Results There were up to 18 cases（ 30. 0%） of malignant arrhythmic events taking as the observation group. SDNN value was significantly less in the observation group than in the control group. LVEDd increased,LVEF decreased,CD_4~＋ T percentage and CD_4~＋/CD_8~＋ both reduced and CD_8~＋ T percentage increased more obviously in the observation group than in the control group（ P〈0. 05）. The levels of FT3 and FT4 in the observation group were significantly lower,while TSH,TGAb and TPOAb levels were higher than those in the control group（ P〈0. 05）. Conclusion Abnormal levels of thyroid hormones and antibodies can certainly guide malignant arrhythmic events in children with mycoplasma pneumoniae and arrhythmia.