儿童先天性心脏病合并支气管肺炎临床辅助检查特点分析.docxVIP

儿童先天性心脏病合并支气管肺炎临床辅助检查特点分析 程学英1张爱青(通讯作者)2杨世伟1秦玉明1 (1南京医科大学附属南京儿童医院心内科 江苏 南京210008) (2南京医科大学第二附属医院儿科 江苏 南京210003) 【摘要】目的：探讨合并先天性心脏病的支气管肺炎住院患儿实验室辅助 检查的特点，指导临床诊疗。方法：收集木地区2013年1月至2014年4月29 例支气管肺炎住院患儿的实验室检查资料，分为先天性心脏病合并支气管肺炎组 17例(A组)和支气管肺炎组12例(B组)，比较两组临床辅助检查的差异。结 果：17例先天性心脏病患儿均存在心脏左向右分流缺陷，两组患儿性别和年龄 均无显著差异(P0.05),实验室辅助检查结果显示两组患儿肌酸激酶同工酶 (CK-MB).天冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、alpha;?瓮基丁酸 脱氢酶(HBDH)等心肌酶谱未见明显差别(P0.05)o体液免疫方面A组和B 组患儿免疫球蛋白IgG和补体C4无显著差异(P0.05), A组患儿IgA、IgM和 补体C3显著低于B组患儿(Plt;0.05)o细胞免疫分析可见两组T细胞比值、辅 助性T细胞比值、抑制性T细胞比值、NK细胞比值和CD4+/CD8+比值无显著差 异(P0.05)o A组患儿心电图异常显著高于B组(Plt;0.05)o结论：先天性心 脏病患儿与普通儿童患支气管肺炎时心肌损害的风险并未增加，先天性心脏病患 儿合并支气管肺炎时体液免疫主要成分IgA、IgM和补体C3显著下降，提示患儿 体液免疫低下或者受到抑制，细菌感染的风险增加，适当的补充免疫球蛋白可能 有利于缓解病情恶化。先天性心脏病患儿心电图异常明显增多，诊疗过程中应常 规监测，做到早发现早治疗，避免累及心功能。 【关键词】先天性心脏病；支气管肺炎；体液免疫 【中图分类号】R72 【文献标识码】A 【文章编号】2095-1752 (2016) 09-0223-02 Analysis of congenital heart disease in children with bronchial pneumonia clin ical assista nt exami nation Che ng Xueyi ngl;Zha ng Aiqing(Com mun icati on author)2,Ya ng Shiweil,Qin Yumingl (1 Department of Cardiology,Nanjing Childrenrsquo; Hospital Affiliated to Nanjing Medical University, Nanjing Jiangsu ,210008, China ;2 Department of pediatric, Second Affiliated Hospital Of Nanjing Medical University, Nanjing Jiangsu ,210003, China) 【Abstract] Objective To investigate the laboratory examination features in hospitalized patients with bronchial pneumonia complicated with congenital heart disease, guide the clinical diagnosis and treatment.Methods Gather the laboratory exami nation materials of this regi on hospitalized childre n with bron chial pn eum onia from 2013 January to 2014 April, divided into A group (17 patients with bronchial pneumonia complicated with congenital heart disease) and B group (12 patients with pneumonia), compare the difference between the two groups of clinical laboratory exami nation .Results The left to right shunt defects exist in 17 childre n with congen ital heart disease, there was no sign ifica ntly d iff ere nee be