本文選題：肺炎支原體感染　切入點：心肌損害　出處：《中華醫(yī)院感染學雜志》2017年01期 　論文類型：期刊論文

【摘要】：目的探討成人肺炎支原體感染(MPP)并發(fā)心肌損害患者C-反應蛋白(CRP)、白介素-6(IL-6)等炎癥指標與心肌酶譜變化,以期為臨床治療提供依據。方法選取2014年1月-2015年12月醫(yī)院收治MPP合并心肌損害患者52例,為A組,另選同期住院MPP患者50例,為B組,非MP感染肺炎患者50例,為C組;B組給予阿奇霉素及對癥治療,A組在B組基礎上給予營養(yǎng)心肌治療,C組給予頭孢菌素藥物治療;于治療前及治療1療程后進行心肌酶譜及炎癥水平測定,觀察三組治療期間心肌酶譜、炎癥水平變化及治療期間不良反應、治療結局。結果治療后,A組心電圖異常、心衰及休克患者發(fā)生率與B、C組對比,差異有統(tǒng)計學意義(P0.05);剔除死亡患者,A組治療后各項心肌酶譜指標、CRP、IL-6、腫瘤壞死因子ɑ(TNF-ɑ)水平均低于同組治療前(P0.05),高于B、C組同期(P0.05),白介素-10(IL-10)高于同組治療前(P0.05),低于B、C組同期(P0.05)。結論成人MPP并發(fā)心肌損害患者炎癥指標及心肌酶譜水平均呈增高狀態(tài),且高于單純MPP及普通肺部感染,隨著有效治療,可使其水平逐漸降低;如單純肺部MPP患者治療過程中,見心肌酶譜、炎癥指標呈增高狀態(tài),應考慮合并心肌損害,給予及早干預,以降低預后不良風險。
[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.
【作者單位】： 南陽市油田總醫(yī)院呼吸內科;鄭州大學第一附屬醫(yī)院呼吸內3科;南陽市第二人民醫(yī)院呼吸內科;南陽市油田總醫(yī)院檢驗科;
【基金】：河南省科技廳科技發(fā)展計劃(13A310113)
【分類號】：R56;R542.2

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