小儿支原体肺炎合并心肌损害的临床分析

Clinical Analysis of Mycoplasma Pneumonia Complicated with Myocardial Damage in Children

目的分析肺炎支原体肺炎(MPP)患儿合并心肌损害的酶学及心电图变化的特点及干预治疗效果。方法随机选取2016年1月~2017年6月我院收治的儿童社区获得性肺炎149例,其中确诊为肺炎支原体肺炎72例,设为观察组(MP组);其余77例普通细菌性肺炎设为对照组(nMP组)。采集两组患儿空腹静脉血,并对其肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)及天门冬氨酸氨基转移酶(AST)等指标进行检测及心电图检查,对结果进行对比分析。结果 MP组心肌酶(AST、LDH、CK、CK-MB)均高于nMP组,两组间差异有统计学意义(P<0.05)。经抗生素及营养心肌治疗后,两组患者的心肌酶异常及心电图异常均2周内恢复正常。结论小儿肺炎支原体肺炎较普通细菌性肺炎更容易发生心肌损害,MPP引发的心肌损害经治疗后大部分恢复正常,提示MPP所致心肌损害预后良好。

Objective To analyze the changes of enzyme and electrocardiogram(ECG)in children with mycoplasma pneumoniae(MPP)complicated with myocardial damage and the effect of intervention.Methods A total of 149 children with community-acquired pneumonia from January 2016 to June 2017 were randomly selected,including 72 cases of mycoplasma pneumoniae pneumonia as observation group(MP group);and 77 cases of common bacterial pneumonia as control group(nMP group).Fasting venous blood samples were collected from the two groups.The indexes of creatine kinase(CK),creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH)and aspartate aminotransferase(AST)were detected and electrocardiogram were compared and analyzed.Results Compared with nMP group,the myocardial enzyme level(AST、LDH、CK、CK-MB)of MP group was significantly higher than that of nMP group,the difference is statically significant(P<0.05).After treatment with antibiotics and nutritious myocardium,the abnormal myocardial enzyme and electrocardiogram returned to normal in 2 weeks.Conclusion Mycoplasma pneumoniae pneumonia in children is more likely to cause myocardial damage than that of common bacterial pneumonia.The majority of myocardial damage caused by MPP recovered to normal after treatment,suggesting that the prognosis of myocardial damage caused by MPP is advanced.