新生儿感染性肺炎血清心肌酶谱水平变化及其与病情严重程度、预后的相关性分析  

Changes of serum myocardial enzymes and its correlation with disease severity and prognosisin neonates with infectious pneumonia

作　　者：张瑞 张东梅[1] 刘雨露[1] ZHANG Rui;ZHANG Dong-mei;LIU Yu-lu

机构地区：[1]商丘市第一人民医院新生儿重症监护室,476000

出　　处：《中国疗养医学》2023年第2期201-204,共4页Chinese Journal of Convalescent Medicine

基　　金：2018年度河南省医学科技攻关计划项目(2018020955),超声诊断在新生儿肺部疾病中的应用研究项目。

摘　　要：目的分析新生儿感染性肺炎(neonatal infectious pneumonia,NIP)血清心肌酶谱水平变化及其与病情严重程度、预后的相关性。方法回顾性分析商丘市第一人民医院2019年5月至2021年12月收治的80例NIP患儿的临床资料,以年龄和性别为配比,同期选取80例行体检的健康新生儿为对照组,比较两组的血清心肌酶谱[天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)]水平;再将80例患儿中肺超声评分(lung ultrasound score,LUSS)<16分的患儿列为病情轻度组、LUSS评分≥16分的患儿列为病情重度组,预后存活的患儿列为预后良好组、预后死亡的患儿列为预后不良组,分析患儿心肌酶谱水平与病情严重程度(重度、轻度)及预后(良好、不良)的相关性。结果研究组患儿的AST、LDH、CK、CK-MB水平均显著高于对照组(P<0.001);病情重度组患儿AST、LDH、CK、CK-MB水平明显高于轻度组(P<0.001);相关分析显示患儿AST、LDH、CK、CK-MB水平与患儿病情严重程度均有正相关性(P<0.05);预后良好组患儿AST、LDH、CK、CK-MB水平低于预后不良组(P<0.001);多因素相关分析显示患儿AST、LDH、CK、CK-MB水平是NIP患儿预后不良的独立危险因素(P<0.05)。结论NIP患儿血清心肌酶谱水平较高,且与患儿的病情严重程度有正相关性,同时也是患儿的预后独立危险因素。Objective To analyze the changes of serum myocardial zymogram levels in neonates with neonatal infectious pneumoni(NIP)and its correlation with the severity and prognosis of the disease.Methods The clinical data of 80 cases of NIP children admitted to the First People’s Hospital of Shangqiu City from May 2019 to December 2021 was collected for retrospective analysis.At the same time,80 healthy newborns undergoing physical examination were selected as the control group,and the levels of serum myocardial enzymes[aspartate aminotransferase(AST),lactate dehydrogenase(LDH),creatine kinase(CK),creatine kinase isoenzyme(CK-MB)]in the two groups were compared by age and sex;Then 80 children with lung ultrasonic score(LUSS)<16 were classified as mild group,those with LUSS score≥16 were classified as severe group,those with survival prognosis were classified as good group,and those with death prognosis were classified as poor group.The correlation between myocardial zymogram level and severity(severe,mild)and prognosis(good,bad)was analyzed.Results The levels of AST,LDH,CK and CK-MB in the study group were significantly higher than those in the control group(P<0.001);The levels of AST,LDH,CK and CK-MB in severe group were significantly higher than those in mild group(P<0.001);Correlation analysis showed that the levels of AST,LDH,CK,CK-MB were positively correlated with the severity of the disease(P<0.05);The levels of AST,LDH,CK,CK-MB in patients with good prognosis were lower than those in patients with poor prognosis(P<0.001);Multivariate correlation analysis showed that AST,LDH,CK,CK-MB levels were independent risk factors for poor prognosis in children with NIP(P<0.05).Conclusion The serum myocardial zymogram level of NIP children is high,and has a positive correlation with the severity of the disease.It is also an independent risk factor for the prognosis of children with NIP.

关 键 词：新生儿感染性肺炎 心肌酶谱 病情严重程度 预后 相关性分析 

分 类 号：R722.135[医药卫生—儿科]