心肌损伤标志物在肺炎患儿中的意义研究

目的分析小儿肺炎心肌损伤标志物活性改变及其临床意义。方法肺炎组44例（重症组9例、轻症组35例）,对照组体检正常儿42例,检测心肌酶（谷草转氨酶AST、α-羟丁酸脱氢酶、α-HBDH、肌酸磷酸激酶同工酶CK-MB）,肌钙蛋白I（CTNI）、肌红蛋白（MYO）活性,进行3组间心肌损伤标志物活性值比较。结果肺炎组患儿的各项心肌损伤标志物均高于正常对照组;重症肺炎组患儿CTnI升高6例,CK-MB升高5例,而轻症肺炎组患儿及正常对照组小儿CTnI值在正常范围内,轻症肺炎组患儿CK-MB升高15例。肺炎组患儿治疗前后心肌损伤标志物的变化,以MYO恢复最快（约起病后1周）,其他依次为α-HBDH、CTNI、AST、CK-MB。结论小儿肺炎时心肌损伤标志物活性呈不同程度增高,以AST活性增高最常见;重症肺炎时常有2项或3项心肌损伤标志物活性同时增高;但以CTNI特异性最高,CK-MB敏感性最高。

The Clinical Significance of the Marker Changing of Myocardial Damage in Children with Pneumonia

Objective To determine the changes of Aspartate aminotransferase(AST),creatine kinase isoenzyme MB(CK-MB),and α-hydroxybutyric dehydrogenase(α-HBDH),Troponin I and Myoglobin,and explore its clinical significance in the children with pneumonia.Methods The myocardial damage markers AST CK-MBα-HBDH Troponin I and Myoglobin were measured in 44 children with pneumonia(including 35 mild cases and 9 severe cases)and 42 normal children,and comparing among the three groups.Results Every marker was higher in pneumonia group than the normal group;CTnI and CK-MB were higher in severe pneumonia group than the other two groups;after the treatment in pneumonia group,the recovery of MYO was the fastest,and then were theα-HBDH,CTNI,AST and CK-MB.Conclusion One of five items increases differently in children with pneumonia at least,usually,the enzyme AST increases.When two or three of items increase at the same time in the severe pneumonia,myocardial damage occurs.The most specificity was the Troponin I;and the most sensitivity was the CK-MB.