心肌酶在肺炎支原体肺炎急性期感染患儿中的水平变化及相关因素分析

Changes of myocardial enzymes in children with acute mycoplasma pneumoniae infection and analysis of related factors

目的探讨心肌酶在肺炎支原体(MP)肺炎急性期感染患儿中的水平变化,并结合临床相关指标和症状体征,评估其对肺炎支原体感染的临床应用价值。方法收集肺炎支原体肺炎(MPP)急性期患儿136例(急性期),同期MPP恢复期患儿100例(恢复期),另选同期体检健康儿童100例(对照组)。应用全自动生化分析仪检测血液中天冬氨酸氨基转移酶(AST)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)水平。结果急性期患儿LDH、CK、CK-MB、AST、PCT、CRP、MPV、PDW、PCt、中性粒细胞百分比、外周血WBC计数、ESR均高于恢复期患儿和对照组,PLT水平低于恢复期和对照组(P<0.05)。急性期患儿CK-MB水平与患儿发热情况、发热持续时间、肺外损害(除心肌损害)、MP抗体滴度均有关(P<0.05)。急性期患儿CK-MB水平与CRP、PCT、外周血WBC计数、MPV、PDW、PCT呈正相关(P<0.05),与患儿年龄、PLT水平呈负相关(P<0.05)。结论肺炎支原体感染急性期检测患儿CK-MB水平不仅能够及时反映患儿心肌损伤情况,并且能够反映MP感染情况、炎症情况和疾病严重程度,对MPP的及时诊治有较好指导价值。

Objective To investigate the changes of myocardial enzymes in children with acute mycoplasma pneumoniae infection and to evaluate the clinical value of myocardial enzymes for mycoplasma pneumoniae infection in combination with clinically relevant indicators and signs and symptoms.Methods 36 children with acute mycoplasma pneumoniae（ MPP） were enrolled in this study.100 children were enrolled in the recovery period of MPP during the same period（ convalescence period） and 100 healthy children as the control group were enrolled in the same period.The levels of AST,CK,CK-MB and LDH in blood were detected by automatic biochemical analyzer.Results The levels of LDH,CK,CK-MB,AST,CRP,PCT,MPV,PDW,PCt,neutrophil percentage,WBC count and ESR in the acute stage group were higher than those in the recovery group and the control group,while the level of PLT in the acute group was lower than that in the recovery and the control group（ P〈0.05）.The level of CK-MB in children with acute phase was related to fever,duration of fever,extrapulmonary（ excluding myocardial damage） and MP antibody titers（ P〈0.05）.The level of CK-MB in acute stage was positively correlated with CRP,TNF-α,IL-6,WBC count,MPV,PDW and PCt,while there was a negative correlation between age and PLT（ P〈0.05）.Conclusion The level of CK-MB in children with acute mycoplasma pneumoniae infection not only can reflect the myocardial injury in time,but also can reflect MP infection,inflammation and disease severity.It is a good guide for timely diagnosis and treatment of MPP.