超敏C反应蛋白在评估儿童支原体肺炎合并心肌损害及预后中的价值

Value of Hypersensitive C-reactive Protein in Evaluating Mycoplasma Pneumonia Complicated with Myocardial Damage and Prognosis in Children

目的:探讨超敏C反应蛋白在儿童支原体肺炎合并心肌损害及其预后评估中的临床价值。方法:选取2015年6月至2017年6月在我科收治的80例MPP患儿,根据血清肌酸激酶同工酶(CK-MB)结果将其分为心肌损害组38例、心肌无损害组42例;40例同期体检的健康儿童为正常对照组。比较心电图(ECG)检测结果及血清CK-MB、超敏C反应蛋白(hs-CRP)水平变化,并分析之间的相关性。结果:①心肌损害组患儿hs-CRP、CK-MB水平均高于心肌无损害组,差异有统计学意义(t=2.69, 2.83, P<0.01)。心肌损害组患儿hs-CRP、CK-MB水平均高于正常对照组,差异有统计学意义(t=2.73, 2.84, P<0.01)。心肌无损害组hs-CRP水平(1.92±0.61mg/L)高于正常对照组(0.79±0.21mg/L),但差异无统计学意义(t=1.72, P>0.05);CK-MB水平与正常对照组比较差异无统计学意义(t=1.65,P>0.05)。血清hs-CRP与CK-MB水平存在正相关(r=0.385,P<0.05)。②心肌损害组患儿hs-CRP、心电图异常率均高于心肌无损害组,差异均有统计学意义(x^2=24.95,28.86,P<0.005)。hs-CRP与心电图异常率存在正相关(r=0.331,P<0.05)。③心肌损害组患儿恢复期hs-CRP、CK-MB水平均明显低于急性期,差异均有统计学意义(t=2.71, 2.85, P<0.01);但与正常对照组比较,差异均无统计学意义(t=1.87, 1.62, P>0.05)。结论:hs-CRP水平可作为评估支原体肺炎并发心肌损害及其预后的参考指标,具有重要的临床应用价值,值得推广。

Objective: To investigate the clinical value of hypersensitive C-reactive protein(hs-CRP) in mycoplasma pneumonia complicated with myocardial damage in children and its prognostic evaluation. Methods: Eighty MPP children admitted to our department from June 2015 to June 2017 were divided into myocardial damage group(38 cases) and non-myocardial damage group(42 cases)according to the results of serum creatine kinase isoenzyme(CK-MB), and 40 healthy children who underwent physical examination at the same time were served as normal control group. The electrocardiogram(ECG)results, serum CK-MB and hs-CRP levels were compared, and the correlation between them was analyzed. Results: ①The levels of hs-CRP and CK-MB in the myocardial damage group were higher than those in the non-damage group(t=2.69, 2.83, P<0.01). The levels of hs-CRP and CK-MB in the myocardial damage group were higher than those in the normal control group(t=2.73, 2.84, P<0.01). The level of hs-CRP in the non-injured myocardium group(1.92±0.61 mg/L) was higher than that in the normal control group(0.79±0.21 mg/L), but there was no significant difference(t=1.72, P>0.05);there was no significant difference between CK-MB and the normal control group(t=1.65, P>0.05). There was a positive correlation between serum hs-CRP and CK-MB(r=0.385, P<0.05). ②The abnormal rates of hs-CRP and ECG in the myocardial damage group were higher than those in the non-damage group(x^2=24.95, 28.86, P<0.005). Hs-CRP was positively correlated with abnormal rate of ECG(r=0.331, P<0.05). ③The levels of hs-CRP and CK-MB in convalescent stage of myocardial damage group were significantly lower than those in acute stage(t=2.71, 2.85, P<0.01), but there was no significant difference compared with normal control group(t=1.87, 1.62, P>0.05). Conclusion: The level of hs-CRP can be used as a reference index for evaluating mycoplasma pneumonia complicated with myocardial damage and its prognosis. It has important clinical application value and is worth popularizing.