成人肺炎支原体感染并发心肌损害患者CRP、IL-6等炎症指标与心肌酶谱变化的研究

发布时间：2018-03-16 08:28

本文选题：肺炎支原体感染　切入点：心肌损害　出处：《中华医院感染学杂志》2017年01期 　论文类型：期刊论文

【摘要】：目的探讨成人肺炎支原体感染(MPP)并发心肌损害患者C-反应蛋白(CRP)、白介素-6(IL-6)等炎症指标与心肌酶谱变化,以期为临床治疗提供依据。方法选取2014年1月-2015年12月医院收治MPP合并心肌损害患者52例,为A组,另选同期住院MPP患者50例,为B组,非MP感染肺炎患者50例,为C组;B组给予阿奇霉素及对症治疗,A组在B组基础上给予营养心肌治疗,C组给予头孢菌素药物治疗;于治疗前及治疗1疗程后进行心肌酶谱及炎症水平测定,观察三组治疗期间心肌酶谱、炎症水平变化及治疗期间不良反应、治疗结局。结果治疗后,A组心电图异常、心衰及休克患者发生率与B、C组对比,差异有统计学意义(P0.05);剔除死亡患者,A组治疗后各项心肌酶谱指标、CRP、IL-6、肿瘤坏死因子ɑ(TNF-ɑ)水平均低于同组治疗前(P0.05),高于B、C组同期(P0.05),白介素-10(IL-10)高于同组治疗前(P0.05),低于B、C组同期(P0.05)。结论成人MPP并发心肌损害患者炎症指标及心肌酶谱水平均呈增高状态,且高于单纯MPP及普通肺部感染,随着有效治疗,可使其水平逐渐降低;如单纯肺部MPP患者治疗过程中,见心肌酶谱、炎症指标呈增高状态,应考虑合并心肌损害,给予及早干预,以降低预后不良风险。
[Abstract]:Objective to investigate the changes of myocardial enzymes in adult patients with Mycoplasma pneumoniae (MPP) complicated with myocardial damage, such as C-reactive protein (CRP) and interleukin-6 (IL-6). Methods from January 2014 to December 2015, 52 patients with MPP complicated with myocardial injury were selected as group A, 50 patients with MPP in the same period were selected as group B and 50 patients with non-MP infection pneumonia. Group C and B were given azithromycin and symptomatic therapy. Group A was given nutritional myocardial therapy on the basis of group B and group C was given cephalosporin, and myocardial enzyme spectrum and inflammatory level were measured before and after one course of treatment. The changes of myocardial enzyme spectrum, inflammatory level, adverse reaction during treatment and treatment outcome were observed in three groups. Results after treatment, the electrocardiogram abnormality, the incidence of heart failure and shock in group A were compared with those in group B and C. After treatment, the levels of all myocardial enzymes in group A (excluding dead patients) were lower than those in the same group before treatment (P 0.05), higher than that in group B (P 0.05), and higher than those in group B (P 0.05) and lower than those in group B (P 0.05) and in group C (P 0.05), respectively, and lower than that in group B (P 0.05), and in group B (P < 0.05) after treatment, and the level of TNF- (TNF-) was lower than that in group B (P < 0.05), but higher than that in group B (P 0.05). Conclusion the inflammatory indexes and myocardial enzyme spectrum of adult patients with MPP complicated with myocardial damage were increased. And higher than simple MPP and common pulmonary infection, with the effective treatment, it can gradually reduce the level, such as simple pulmonary MPP patients, see myocardial enzyme spectrum, inflammatory indicators show an increased state, should be considered with myocardial damage, Early intervention was given to reduce the risk of poor prognosis.
【作者单位】：南阳市油田总医院呼吸内科;郑州大学第一附属医院呼吸内3科;南阳市第二人民医院呼吸内科;南阳市油田总医院检验科;
【基金】：河南省科技厅科技发展计划(13A310113)
【分类号】：R56;R542.2

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