Variation and clinical significance of myocardial enzymes in children with Henoch-Sch(o)nlein purpura
10.3760/cma.j.issn.1673-4904.2014.03.008
- VernacularTitle:过敏性紫癜患儿心肌酶谱改变及其临床意义
- Author:
Shuxiang SUI
- Publication Type:Journal Article
- Keywords:
Purpura,Sch(o)nlein-Henoch;
Troponin Ⅰ;
Myocardial enzyme;
Child
- From:
Chinese Journal of Postgraduates of Medicine
2014;37(3):23-26
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effects of Henoch-Sch(o)nlein purpura (HSP) on myocardium and clinical significance of myocardial enzymes,and to guide the application of drugs which benefit myocardium by analysis of myocardial enzymes.Methods A total of 158 children with HSP and 50 healthy chidren (control group) were collected.Children with HSP according to the affected area were divided into simple group (skin involvement only,63 cases) and mixed group (skin involvement combined with joint symptoms,gastrointestinal symptoms,kidney symptoms and others,95 cases).The fasting venous blood were collected for measurement of cardiac troponin Ⅰ (cTnⅠ),α-hydroxybutyrate dehydrogenase (HBDH),aspartictransaminase (AST),lactic dehydrogenase (LDH),creatine kinase-MB (CK-MB),creatine kinase (CK) by Japan Hitachi 7600-020 automatic analyzer.Electrocardiogram was recorded in children with abnormality of cTnⅠ and myocardial enzyme.Results In simple group and mixed group,the values of cTnⅠ,CK-MB,α-HBDH,AST,LDH were significantly higher than those in control group [(1.41 ± 0.61),(1.86 ± 0.92) μg/L vs.(0.66 ±0.39) μg/L,(19.60 ±11.28),(28.12 ±6.00) U/L vs.(14.64 ±4.41) U/L,(258.00 ± 52.73),(327.90 ± 65.60) U/L vs.(158.40 ± 45.11) U/L,(35.7 ± 7.2),(39.6 ± 12.0) U/L vs.(27.2 ± 7.3) U/L,(300.5 ± 80.0),(320.5 ± 65.0) U/L vs.(260.0 ± 30.0) U/L](P＜ 0.05).In mixed group,the values of cTnⅠ,CK-MB,α-HBDH were significantly higher than those in simple group (P＜0.05).In mixed group,the values of AST,LDH showed no significant difference when compared with that of the simple group (P＞ 0.05).In simple group,one or more indicators were elevated in 16 cases; in mixed group,one or more indicators were elevated in 39 cases.There was significant difference between two groups in abnormal rate of cTnⅠ,CK-MB,α-HBDH [15.87％(10/63) vs.30.53％(29/95),7.94％(5/63) vs.21.05％ (20/95),11.11％(7/63) vs.24.21％ (23/95)] (P ＜0.05).Electrocardiographic results in children with abnormal myocardial enzymes showed that tachycardia occurred in 15 cases (4 cases of simple group,11 cases of mixed group).Bradycardia occurred in 2 cases in mixed group.Sinus arrhythmia occurred in 10 cases (4 cases of simple group,6 cases of mixed group),no other arrhythmia presented.Conclusions Some of HSP children may present with abnormality of myocardial enzymes.Changes of myocardial enzymes in mixed group are more significantly than those in simple group.In HSP children complicated with myocardial damage,there are no specific changes in electrocardiogram.
