血清CK、CKMB、LDH对儿童肺炎支原体肺炎心肌损伤的诊断价值  

Diagnostic value of serum CK,CKMB and LDH in myocardial injury of children with mycoplasma pneumoniae pneumonia

作　　者：许高峰 吴秋珍 Xu Gao-feng;Wu Qiu-zhen(Department of Laboratory,Xiwu People's Hospital,Xiuwu 454350,Henan,China)

机构地区：[1]修武县人民医院检验科,河南修武454350

出　　处：《四川生理科学杂志》2025年第2期347-349,441,共4页

摘　　要：目的:观察相关血清酶学检测在儿童肺炎支原体肺炎(Mycoplasma pneumoniae pneumonia,MPP)合并心肌损伤(Myocardial damage,MD)患儿中的变化,并分析血清因子的价值。方法:选取2021年7月至2023年1月期间本院收治的122例MPP患儿作为研究对象。依据是否合并心肌损伤,将MPP患儿分为非心肌损伤组(MPP组)和心肌损伤组(MPP+MD组)。治疗前(入院确诊后)、治疗后7 d测定并对比两组血清肌酸激酶(Creatine kinase,CK)、肌酸激酶同工酶MB(Creatine kinase MB isoenzyme,CKMB)、乳酸脱氢酶(Lactate dehydrogenase,LDH)。分析血清CK、CKMB、LDH与MPP合并MD的相关性及对MPP合并MD的诊断价值。结果:所有MPP患儿依据是否合并心肌损伤分为非心肌损伤组(MPP组,n=91)和心肌损伤组(MPP+MD组,n=31)。MPP+MD组的血清CK、CKMB、LDH均显著高于MPP组(P<0.05)。MPP+MD组治疗后的血清CK、CKMB、LDH均显著低于治疗前(P<0.05)。Logistic回归结果显示CK(OR=1.017,P=0.016)、CKMB(OR=1.230,P=0.002)、LDH(OR=1.055,P=0.004)均为MPP合并MD的独立危险因素(P<0.05)。血清CK、CKMB、LDH单独诊断MPP合并MD的AUC为0.843、0.873、0.888,敏感度为0.839、0.871、0.839,特异度为0.989、0.989、0.945;三项联合后AUC提高为0.994、敏感度为0.968,且三项联合AUC高于血清CK、CKMB、LDH单独诊断(P<0.05)。结论:MPP合并MD患儿血清CK、CKMB、LDH异常升高,且均可作为诊断合并MD的血清指标。Objective:To observe the changes of serum enzymatic detection in children with Mycoplasma pneumoniae pneumonia(MPP)complicated with Myocardial damage(MD)and to analyze the value of serum factors.Methods:A total of 122 children with MPP admitted to our hospital from July 2021 to January 2023 were selected as the study objects.Children with MPP were divided into two groups:non-myocardial injury group(MPP group)and myocardial injury group(MPP+MD group).Serum creatine kinase(CK),creatine kinase MB isoenzyme(CKMB)and lactate dehydrogenase(LDH)were measured and compared between the two groups before treatment(after admission diagnosis)and 7 days after treatment.To analyze the correlation of serum CK,CKMB,LDH and MPP combined with MD and the diagnostic value of MPP combined with MD.Results:All children with MPP were divided into non-myocardial injury group(MPPgroup,n=91)and myocardial injury group(MPP+MD group,n=31).The serum CK,CKMB and LDH in MPP+MD group were significantly higher than those in MPP group(P<0.05).The serum CK,CKMB and LDH of MPP+MD group after treatment were significantly lower than those before treatment(P<0.05).Logistic regression results showed that CK(OR=1.017,P=0.016),CKMB(OR=1.230,P=0.002),LDH(OR=1.055,P=0.004)were independent risk factors for MPP combined with MD(P<0.05).The AUC of serum CK,CKMB,LDH for MPP combined with MD was 0.843,0.873,0.888,the sensitivity was 0.839,0.871,0.839,and the specificity was 0.989,0.989,0.945.After three combinations,the AUC was increased to 0.994,the sensitivity was 0.968,and the AUC of three combinations was higher than that of serum CK,CKMB,LDH alone(P<0.05).Conclusion:Serum CK,CKMB and LDH are abnormally elevated in MPP patients with MD,which can be used as serum indexes for diagnosis of MD.

关 键 词：肺炎支原体肺炎 心肌损伤 心肌酶谱 LDH 

分 类 号：R725.6[医药卫生—儿科]