临床儿科杂志 ›› 2020, Vol. 38 ›› Issue (12): 905-.doi: 10.3969/j.issn.1000-3606.2020.12.006

• 呼吸系统疾病专栏 • 上一篇    下一篇

新型冠状病毒感染儿童心肌损伤的研究

易兰芬,邱梅,文红霞   

  1. 华中科技大学同济医学院附属武汉儿童医院心电图室(湖北武汉 430016)
  • 出版日期:2020-12-15 发布日期:2020-12-18
  • 通讯作者: 文红霞 电子信箱:380947312@qq.com

Myocardial injury in children infected with 2019 novel coronavirus

YI Lanfen, QIU Mei, WEN Hongxia   

  1. Department of Electrocardiogram, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430016 , Hubei, China
  • Online:2020-12-15 Published:2020-12-18

摘要: 目的 探讨新型冠状病毒(COVID-19)感染儿童心肌损伤的情况。方法 回顾性分析2020年1月28日至 2020年3月7日就诊,经临床表现、肺部CT及核酸检测确诊为COVID- 19感染的33例患儿的心电图及心肌酶谱检测结 果;将患儿分为轻型组和普通型组,对比两组心律失常情况和心肌酶谱指标的差异,以及患儿年龄与心肌酶谱的相关性。 结果 33例患儿中男20例、女13例,心律失常8例(24.2%),心肌酶谱异常11例(33.3%),均出现在普通型。普通型患 儿心律失常发生率高于轻型患儿,差异有统计学意义(P

关键词: 新型冠状病毒; 心电图; 心律失常; 心肌酶谱; 儿童

Abstract: Objective To explore the situation of myocardial injury in children infected with 2019 novel coronavirus (COVID- 19 ). Methods The electrocardiogram and myocardial enzyme spectrum in 33 children with COVID- 19 infection diagnosed by clinical manifestations, lung CT and nucleic acid detection from January 28 , 2020 to March 7 , 2020 were retrospectively analyzed. The children were divided into the mild symptom group and the general symptom group. The differences of arrhythmia status and myocardial enzyme spectrum indexes between the two groups were compared and the correlation between the age of the children and myocardial enzyme spectrum was analyzed. Results Among the 33 children ( 20 boys and 13 girls), 8 ( 24 . 2 %) had arrhythmia and 11 ( 33 . 3 %) had abnormal myocardial enzyme spectrum, all of whom were from the general symptom group. The incidence of arrhythmia in the general symptom group was higher than that in the mild symptom group, and the difference was statistically significant (P< 0 . 05 ). Arrhythmias are often manifested as sinus tachycardia. The abnormal rates of lactate dehydrogenase (LDH), LDH isoenzyme 1 (LD 1 ) and creatine kinase isoenzyme (CK-MB) were 42 . 9 % ( 9 /21 ), 38 . 1 % ( 8 /21 ), and 47 . 6 % ( 10 /21 ) respectively in the general symptom group, which were higher than those in the mild symptom group (all P< 0 . 05 ). The levels of mean LDH, LD 1 , and median CK-MB in the general symptom group were higher than those in the mild symptom group, and the difference was statistically significant (P< 0 . 05 ). The age of children with COVID-19 infection is significantly negatively correlated with the levels of LDH, LD1, CK, and CK-MB (r=-0.563~-0.458, P< 0 . 01 ). Conclusions? Children with COVID- 19 infection have different degrees of myocardial damage. Sinus tachycardia is common manifestation. Multiple indexes of myocardial enzymes are elevated. The myocardial damage was more severe in the younger child with more severe symptoms.

Key words: 2019 -novel coronavirus; electrocardiogram; arrhythmia; myocardial enzyme spectrum; child