热性惊厥合并感染患儿血清hs-CRP、hs-cTnI、CK-MB与心肌损伤的关系

Relationship between serum hs-CRP,hs-cTnI,CK-MB and myocardial injury in children with febrile convulsion and infection

目的 研究热性惊厥(FC)合并感染患儿血清超敏C反应蛋白(hs-CRP)、超敏心肌肌钙蛋白I(hs-cTnI)、肌酸激酶同工酶(CK-MB)与心肌损伤的关系。方法 选择广安市人民医院2018年3月-2021年6月诊治的95例FC合并感染患儿,其中FC合并感染患儿61例(对照组),并发心肌损伤组患儿34例(研究组)。检测其血清hs-CRP、hscTnI、CK-MB水平,分析hs-CRP与hs-cTnI、CK-MB水平相关性,并采用Logistic回归分析影响患儿并发心肌损伤的危险因素,并分析血清指标水平的预测价值。结果 研究组患儿心电图异常率以及血清hs-CRP、hs-cTnI、CK-MB水平均显著高于对照组(P<0.05),其余指标比较无统计学意义(P>0.05);血清hs-CRP与hs-cTnI、CK-MB水平均呈正相关(P<0.05);Logistic回归分析结果显示血清hs-CRP、hs-cTnI、CK-MB水平均是影响FC合并感染患儿发生心肌损伤的危险因素(P<0.05),三者对于FC合并感染患儿心肌损伤的发生均具有较好的预测价值,联合检测的曲线下面积(AUC)值、敏感度显著高于单一指标预测(P<0.05)。结论 FC合并感染患儿心肌损伤的发生与机体炎症反应密切相关,且血清hs-CRP、hs-cTnI、CK-MB水平均为影响心肌损伤发生的独立危险因素,三者联合检测对于预测心肌损伤的发生具有较好的价值。

Objective To study the relationship between serum high-sensitivity C-reactive protein(hs-CRP),highsensitivity cardiac troponin I(hs-cTnI),creatine kinase isoenzyme(CK-MB)and myocardial injury in children with febrile convulsion(FC)and infection.Methods A total of 95children with FC and infection who were diagnosed and treated in the hospital were selected as the research subjects between March 2018and June 2021.According presence or absence of myocardial injury,the children enrolled were divided into control group(n=61,without myocardial injury)and study group(n=34,with myocardial injury).Peripheral venous blood samples were collected from all subjects to detect serum hs-CRP,hs-cTnI and CK-MB levels.The correlation of hs-CRP with hs-cTnI and CK-MB was analyzed.Logistic regression analysis was performed to screen the risk factors of myocardial injury in children with FC and infection.The receiver operating characteristic curve(ROC)was plotted to analyze the predictive value of serum hs-CRP,hscTnI and CK-MB levels for myocardial injury in children with FC and infection.Results There was no statistically significant difference in gender,age and initial body temperature between the two groups(P>0.05).The rate of abnormal ECG,serum hs-CRP,hs-cTnI and CK-MB levels in study group were significantly higher than those in the control group(P<0.05).Serum hs-CRP was positively correlated with hs-cTnI and CK-MB levels(P<0.05).Logistic regression analysis showed that serum hs-CRP,hs-cTnI and CK-MB levels were risk factors influencing myocardial injury in children with FC and infection(P<0.05).Serum hs-CRP,hs-cTnI and CK-MB levels all could be used to predict myocardial injury in children with FC and infection.The area under the curve(AUC)value and sensitivity of joint prediction were significantly higher than those of single prediction(P<0.05).Conclusion The occurrence of myocardial injury in children with FC and infection is closely related to inflammatory response.Serum hs-CRP,hs-cTnI and CK-MB levels are independent risk factors affecting the occurrence of myocardial injury.Joint detection of the three is useful for predicting myocardial injury.