肺炎患儿心肌损伤标志物改变的临床意义

目的：探讨小儿肺炎时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、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，进行三纽间心肌损伤标志物活性值的比较。结果：肺炎组惠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（66．7％）6／9例升高，CK—MB（55．6％）5／9例升高，而轻症肺炎组惠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（42．9％）15／35例升高。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；重症肺炎时常有二项或三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）, andα--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--MB α--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.