心肌酶谱联合C-反应蛋白用于新生儿肺炎病情评估中的意义研究

摘要

目的 观察心肌酶谱联合C-反应蛋白(CRP)检测用于新生儿肺炎病情评估中的意义.方法 选择新生儿肺炎91例为观察组,足月健康新生儿48例为健康对照组,健康对照组于入组后,观察组患儿于入组后及入组后第5天、10天空腹抽取肘静脉血,离心分离血清检测心肌酶指标(包括CK、CK-MB、AST及LDH)及CRP.结果 观察组患儿心肌酶谱各项指标及血清CRP水平均显著高于正常对照组,差异均有统计学意义(P<0.05).不同病情心肌酶谱及血清CRP水平比较显示,重症患儿组均高于对照组,比较差异有统计学意义(P<0.05).不同病原感染患儿心肌酶谱指标及CRP水平比较显示,细菌性及支原体肺炎患儿心肌酶谱指标水平低于病毒性患儿,差异显著(P<0.05);细菌性与支原体肺炎相比,细菌性感染新生儿肺炎 CK、AST、CK-MB、AST、LDH 低于支原体感染患儿(P <0.05).3组CRP水平比较显示,细菌性感染新生儿肺炎高于病毒性感染及支原体感染组,比较差异显著(P<0.05).不同分期新生儿肺炎心肌酶谱指标及血清CRP水平比较显示,新生儿肺炎急性期心肌酶谱指标及血清CRP水平均高于恢复期,差异有统计学意义(P<0.05).结论 心肌酶谱增高与新生儿肺炎病情呈正相关,检测心肌酶谱有助于早期发现心肌损害及判断损害程度,同时检测CRP有助于正确判断细菌性和非细菌性肺炎.%Objective To investigate the significance of combined detection of myocardial enzymes with C-reactive protein in evaluation of disease condition of neonatal pneumonia.Methods Forty-nine neonates with pneumonia were enrolled as observation group,at the same time,the other 48 healthy mature neonates were enrolled as control group. The serum levels of CK, CK-MB, AST,LDH and CRP were detected and compared between two groups. Results The serum levels of myocardial enzymes indexes and CRP in observation group were significantly higher than those in control group (P<0.05). The serum levels of myocardial enzymes indexes and CRP in severe case of observation group were significantly higher than those in control group (P <0.05). Moreover the serum levels of myocardial enzymes indexes and CRP in patients with bacterial and mycoplasma pneumonia were significantly lower than those of patients with viral pneumonia (P<0.05). The serum levels of CK,AST,CK-MB, AST,LDH in patients with bacterial pneumonia were significantly lower than those of patients with mycoplasma pneumonia (P<0.05). In addition the serum levels of CRP in patients with bacterial pneumonia were significantly higher than those of patients with mycoplasma pneumonia and those of patients with viral pneumonia (P<0.05). Besides the serum levels of myocardial enzymes indexes and CRP in patients with neonatal pneumonia at acute stage were significantly higher than those of patients with neonatal pneumonia at convalescence stage(P<0.05).Conclusion The increase of myocardial enzymes spectrum is positively correlated with the disease condition of neonatal pneumonia. The detection of myocardial enzymes is helpful to early detect the damage of myocardium and evaluate the degree of damage, moreover,combined detection with CRP is beneficial to judge correctly bacteria pneumonia and non-bacterial pneumonia.