| 郭建明,刘春燕,刘飞飞,等.可溶性 ACE2水平与支原体肺炎病儿心肌损伤间关系的初步探讨[J].安徽医药,2025,29(1):118-122. |
| 可溶性 ACE2水平与支原体肺炎病儿心肌损伤间关系的初步探讨 |
| A preliminary study on the relationship between soluble ACE2 level and myocardial injury in children with mycoplasma pneumonia |
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| DOI：10.3969/j.issn.1009-6469.2025.01.024 |
| 中文关键词: 肺炎，支原体 可溶性血管紧张素转换酶 2 心肌损伤 影响因素 预测价值 |
| 英文关键词: Pneumonia,mycoplasma Soluble angiotensin converting enzyme 2 Myocardial damage Influencing factors Pre-dictive value |
| 基金项目:河北省医学科学研究课题计划项目( 20232082) |
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| 中文摘要: |
| 目的分析可溶性血管紧张素转换酶 2(sACE2)水平与肺炎支原体肺炎(MPP)病儿心肌损伤的关系。方法收集 2021年 2月至 2022年 11月中国人民解放军陆军第八十一集团军医院收治的 MPP病儿 108例，根据病情严重程度分为重症 MPP组 30例和轻症 MPP组 78例，选取同期健康体检儿童 50例为对照组；根据 MPP病儿是否发生心肌损伤分为发生组 23例和未发生组 85例。酶联免疫吸附测定检测血清 sACE2水平；收集 MPP病儿临床病历资料及生化指标水平，并进行组间比较； Pearson法分析 sACE2与生化指标的相关性； logistic回归分析 MPP病儿发生心肌损伤的影响因素； ROC曲线分析 sACE2水平对 MPP病儿发生心肌损伤的预测价值。结果重症 MPP组、轻症 MPP组、对照组儿童血清 sACE2水平［(56.19±6.13)U/L、(42.36±6.02)U/L、(28.15±5.97)U/L］依次降低，心肌损伤发生组 MPP病儿血清 sACE2水平高于未发生组(P<0.05)；发生组和未发生组 MPP病儿发热程度、肺炎支原体(MP)抗体滴度、发热持续时间、大环内酯类药物使用时间、咳嗽性质、其他肺外并发症、胸片表现、心电图异常、 C反应蛋白(CRP)、乳酸脱氢酶(LDH)肌酸激酶同工酶(CK-MB)、磷酸肌酸激酶(CK)红细胞分布宽度(RDW)心肌肌钙蛋白(cTnI)、 N-末端脑钠肽前体(NT-proBNP血小板计数(PLT)比较差异有统计学意义(P<05)； sACE2水平与 LDH、 T-proBNP、cTnI、CK、)、.0、N、RDW、CRP呈正相关，与 PLT呈负相关(P<0.05)； sACE2、CK-MB是 MPP病儿发生心肌损伤的影响因素(P<0.05)； sACE2水平评估 MPP病儿发生心肌损伤的 AUC为 0.94［95%CI:(0.88，0.98)］灵敏度和特异度分别为 86.96%和 85.88%。结论 sACE2水平与 MPP病儿心肌损伤具有密切关系，是 MPP病儿发生心肌损伤的影，响因素，对心肌损伤的发生具有一定预测价值。 |
| 英文摘要: |
| Objective To analyze the relationship between soluble angiotensin converting enzyme 2 (sACE2) level and myocardial in-jury in children with Mycoplasma pneumoniae pneumonia (MPP).Methods A total of 108 children with MPP admitted to 81st GroupMilitary Hospital from February 2021 to November 2022 were collected. According to the severity of the condition, they were groupedinto a severe MPP group of 30 cases and a mild MPP group of 78 cases. Fifty healthy children who underwent physical examination dur-ing the same period were collected as the control group; children with MPP were grouped into an occurrence group of 23 cases and annon occurrence group of 85 cases based on whether they experienced myocardial injury. Enzyme-linked immunosorbent assay was ap-plied to measure serum sACE2 level; clinical medical record data and biochemical indicators of MPP children were collected, and com-pared between groups; Pearson method was applied to analyze the correlation between sACE2 and biochemical indicators; Logistic re-gression was applied to analyze the influencing factors of myocardial injury in children with MPP; ROC curve was applied to analyzethe predictive value of sACE2 level for myocardial injury in children with MPP.Results The serum level of sACE2 in children with se-vere MPP group, mild MPP group, and control group [(56.19±6.13)U/L, (42.36±6.02)U/L, (28.15±5.97)U/L] decreased sequentially, theserum level of sACE2 in children with MPP in the occurrence group were higher than those in the non occurrence group (P<0.05); thedifferences in fever severity, MP antibody titer, duration of fever, duration of macrolide medication use, cough properties, other extrapul-monary complications, chest X-ray manifestations, electrocardiogram abnormalities, C-reactive protein (CRP) , lactate dehydrogenase (LDH) , creatine kinase (CK-MB), phosphocreatine kinase (CK) , red blood cell distribution width (RDW) , cardiac troponin (cTnI), N-terminal pro-B-type natriureticpeptide (NT-proBNP) and platelet count (PLT) were statistically obvious (P<0.05); the level of sACE2was positively correlated with LDH, NT proBNP, cTnI, CK, RDW, CRP, and negatively correlated with PLT (P<0.05); SACE2 and CK-MB were influencing factors for myocardial injury in MPP children (P<0.05); the AUC of myocardial injury in MPP patients evaluated by sACE2 level was 0.94 [95%CI:(0.88,0.98)], with sensitivity and specificity of 86.96% and 85.88%, respectively.Conclusions The level of sACE2 is closely related to myocardial injury in children with MPP, and is a influencing factor for the occurrence of myocardialinjury in children with MPP. It has certain predictive value for the occurrence of myocardial injury. |
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