肌酸激酶同工酶、肌钙蛋白、B型利钠肽前体在重症肺炎患儿心肌损伤中的应用价值  

Application value of creatine kinase isoenzyme,troponin and pro⁃B⁃type natriuretic peptide in myocardial injury of children with severe pneumonia

作　　者：梁卓信 张森雄 傅锦坚 叶小华 LIANG Zhuoxin;ZHANG Senxiong;FU Jinjian;YE Xiaohua(Department of Critical Care Medicine,Department of Prevention and Health Care,Liuzhou Maternity and Child Health Care Hospital,Liuzhou 545001,China;School of Public Health,Guangdong Pharmaceutical University,Guangzhou 510310,China)

机构地区：[1]柳州市妇幼保健院重症医学科和预防保健科,广西柳州545001 [2]广东药科大学公共卫生学院,广东广州510310

出　　处：《广东药科大学学报》2021年第1期138-141,共4页Journal of Guangdong Pharmaceutical University

基　　金：广东省基础与应用基础研究基金(2019A1515010915);广西壮族自治区卫健委课题(Z20170540)。

摘　　要：目的检测肺炎患儿的心肌损伤标志物肌酸激酶同工酶(CK‐MB)、肌钙蛋白(cTnI)和N末端B型利钠肽前体(NT‐pro‐BNP),用于儿童重症肺炎患者心肌损伤中的早期预警能力。方法纳入轻症肺炎和重症肺炎患儿各120例,检测患儿血样的CK‐MB、cTnI和NT‐pro‐BNP。采用非参数检验分析2组间或3组间的CK‐MB、cTnI和NT‐pro‐BNP水平。结果轻症患儿的心肌损伤标志物CK‐MB、cTnI和NT‐pro‐BNP的含量均明显低于重症组;随着疾病病程加重(即PCIS评分的降低),心肌损伤标志物水平随之升高;合并心肌损伤组的心肌损伤标志物水平明显高于非心肌损伤组,其差异具有统计学意义(均为P<0.05)。结论重症肺炎合并心肌损伤患儿的血清CK‐MB、cTnI和NT‐pro‐BNP水平升高,CK‐MB、cTnI和NT‐pro‐BNP水平的改变可作为重症肺炎患儿心肌损伤的可靠预警生物标志物之一。Objective To detect the markers of myocardial injury in children with pneumonia,including creatinekinaseMB(CK‑MB),troponin I(cTnI)and N‐terminalpro‑B‑type natriuretic peptide(NT‑pro‑BNP).Methods 120 children with mild pneumonia and 120 children with severe pneumonia were enrolled.The serum levels of CK‑MB,cTnI and NT‑pro‑BNP were measured.The nonparametric test was used to analyze the results of CK‑MB,cTnI and NT‑pro‑BNP between the two or three groups.Results The levels of myocardial injury biomarkers CK‑MB,c TnI and NT‑pro‑BNP in the mildpneumonia group were significantly lower than those in the severe pneumonia group.With the aggravation of the disease course(that is,the decrease of PCIs score),the levels of myocardial injury markers were increased.The level of myocardial injury markers in the combined myocardial injury group was significantly higher than that in the non‑myocardial injury group.Conclusion The serum levels of CK‑MB,cTnI and NT‑pro‑BNP may increase in children with severe pneumonia complicated with myocardial injury,which can be used as one of the early warning biomarkers for this disease.

关 键 词：肌酸激酶同工酶 肌钙蛋白 B型利钠肽前体 重症肺炎 心肌损伤 

分 类 号：R725[医药卫生—儿科]