摘要
目的 探究外周血25-羟维生素D[25-(OH)-D]、D-二聚体及QT离散度与支气管肺炎患儿心肌损伤标志物的相关性.方法 前瞻性选取2020年1月至2022年1月池州市第二人民医院收治的45例支气管肺炎伴心肌损伤患儿纳入研究组,另按照1:1的比例随机抽取45例在本院接受治疗的支气管肺炎未发生心肌损伤患儿纳入对照组.对两组患儿的心肌损伤标志物[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、肌钙蛋白T(cTnT)及N-末端脑钠肽前体(NT-proBNP)]水平进行记录,采用Pearson相关性分析探究患儿心肌损伤标志物水平与外周血25-(OH)-D、D-二聚体及QT离散度的相关性;采用受试者操作特征(ROC)曲线探究上述指标对支气管肺炎患儿发生心肌损伤的诊断价值.结果 研究组患儿的 CK、CK-MB、cTnT 及 NT-proBNP 水平分别为(185.46±18.33)U/L、(62.45±8.44)U/L、(1.89±0.36)μg/mL、(287.65±45.12)ng/L,均高于对照组患儿[(82.22±11.02)U/L、(20.58±4.15)U/L、(0.44±0.12)μg/mL、(122.45±25.15)ng/L],差异均有统计学意义(P＜0.05).研究组患儿 25-(OH)-D 水平为(53.45±6.11)nmol/L,低于对照组[(74.45±5.15)nmol/L],D-二聚体、QT 离散度水平分别为(3.98±1.18)μg/mL、(33.18±1.98)ms,均高于对照组[(2.11±0.54)μg/mL、(25.15±2.16)ms],差异均有统计学意义(P＜0.05).经Pearson相关性分析可知,患儿的CK、cTnT、CK-MB及NT-proBNP水平均与25-(OH)-D水平呈负相关(P＜0.05),与D-二聚体、QT离散度水平呈正相关(P＜0.05).经ROC曲线分析可知,外周血25-(OH)-D、D-二聚体、QT离散度均对支气管肺炎患儿心肌损伤具有一定诊断价值,其曲线下面积值分别为0.854、0.843、0.894、0.827(P＜0.05).结论 支气管肺炎患儿25-(OH)-D、D-二聚体、QT离散度与其心肌损伤存在显著相关性,且各指标对支气管肺炎并发心肌损伤均存在一定诊断价值.
Abstract
Objective To explore the correlation between peripheral blood 25-hydroxy vitamin D[25-(OH)-D],D-dimer and QT dispersion and markers of myocardial injury in children with bronchopneumonia.Methods Forty-five children with bronchopneumonia and myo-cardial injury admitted to The Second People's Hospital of Chizhou from January 2020 to January 2022 were prospectively selected as the study group,and 45 children with bronchopneumonia without myocardial injury treated in the same hospital were randomly selected as the control group according to the ratio of 1∶1.The myocardial injury marker levels of the two groups were recorded,and Pearson correlation analysis was used to ex-plore the correlation between the levels of myocardial injury markers[creatine kinase(CK),creatine kinase-MB(CK-MB),cardiac troponin T(cTnT),N-Terminal pro b-type natriuretic peptide(NT-proBNP)]and peripheral blood 25-(OH)-D,D-dimer and QT dispersion.The diagnostic value of the above indicators for myocardial injury in children with bronchial pneumonia was explored using the receiver operating characteristic(ROC)curve.Results The levels of CK,CK-MB,cTnT and NT-proBNP in the study group were(185.46±18.33)U/L,(62.45±8.44)U/L,(1.89±0.36)pg/mL and(287.65±45.12)ng/L,respectively,which were higher than those in the control group[(82.22±11.02)U/L,(20.58±4.15)U/L,(0.44±0.12)μg/mL,(122.45±25.15)ng/L],the differences were statistically significant(P＜0.05).The level of 25-(OH)-D in the study group was(53.45±6.11)nmol/L,which was lower than that in the control group[(74.45±5.15)nmol/L],the levels of D-dimer and QT dispersion were(3.98±1.18)μg/mL and(33.18±1.98)ms,respectively,which were higher than those in the control group[(2.11±0.54)μg/mL and(25.15±2.16)ms],and the differences were statistically signifi-cant(P＜0.05).According to the Pearson correlation analysis,the levels of creatine kinase,troponin T,creatine kinase isoenzyme and N-ter-minal brain natridium peptide precursor were negatively correlated with the levels of 25-(OH)-D,and positively correlated with D-dimer and QT dispersion levels(P＜0.05).According to the ROC curve analysis,we showed that peripheral blood 25-(OH)-D,D-dimer,and QT dis-persion all had some diagnostic value for myocardial injury in children with bronchopneumonia,and their AUC values were 0.854,0.843,0.894,and 0.827,respectively(P＜0.05).Conclusion 25-(OH)-D,D-dimer and QT dispersion in children with bronchopneumonia were significantly correlated with their myocardial injury,and each index had some diagnostic value for bronchopneumonia complicated by myocardial injury.
基金项目
安徽省卫生计生委科研计划项目(2017ek009)
NETL
NSTL
万方数据