小儿动态心电图不同时段参数与感染性心内膜炎赘生物的直径与数量的相关性

doi:10.3969/j.issn.1006-6233.2023.11.024

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摘要 目的: 探究小儿动态心电图不同时段参数与感染性心内膜炎患儿的诊断价值。方法: 选取2017年1月至2021年6月90例于我院就诊的疑似感染性心内膜炎患儿,超声心动图及血培养确诊感染性心内膜炎患儿62例设为观察组,剩余28例患儿设为对照组,两组患儿均行小儿动态心电图扫描,对比两组患儿不同时段参数,酶联免疫吸附法检测血清IL-6、cTn I水平,采用免疫比做法检测血清CRP水平,分析患儿的心内膜赘生物直径大小、数量对感染性心内膜炎的诊断价值。结果: 与对照组患儿比较,观察组患儿动态心电图参数正常R-R周期标准差平均数(SDNN)、相邻R-R周期差值均方根(rMSSD)、正常R-R周期标准差大于50ms占总周期的百分比(PNN50),水平较低(P<0.05)。与感染早期患儿比较,感染晚期患儿12h、24h参数SDNN、rMSSD、PNN50水平较低(P<0.05)。与感染早期患儿比较,感染晚期患儿血清指标CRP、IL-6、cTn I水平升高(P<0.05)。感染晚期患儿赘生物的直径<2mm和2~15mm与数量水平1个和2~3低于感染早期患儿赘生物的直径<2mm和2~15mm与数量水平1个和2~3,直径>15mm与数量水平>3个高于感染早期患儿赘生物的直径>15mm与数量水平>3。SDNN、rMSSD、rMSSD、CRP、IL-6、cTn I、赘生物直径大小与数量联合诊断对感染性心内膜炎的诊断价值较高。结论: 小儿动态心电图不同时间段参数与感染性心内膜炎血清指标CRP、IL-6与cTnⅠ水平和感染性心内膜炎心腔赘生物的直径与数量诊断价值较高,为早期预防、治疗感染性心内膜炎提供借鉴指导。

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关键词 ：小儿动态心电图, 不同时段参数, 感染性心内膜炎, 血清CRP, 血清IL-6

Abstract：Objective: To investigate the diagnostic value of different time parameters of Holter electrocardiography in children with infective endocarditis. Methods: A total of 90 children with suspected infective endocarditis who were treated at our hospital from January 2017 to June 2021 were selected.Among them,62 children with infective endocarditis confirmed by echocardiography and blood culture were assigned to the observation group,while the remaining 28 children were placed in the control group.Both groups underwent pediatric Holter electrocardiogram scanning.We compared various parameters at different time periods between the two groups.Enzyme-linked immunosorbent assay was used to measure serum IL-6 and cTnI levels,and serum CRP levels were determined using the immunoratio method.The diagnostic value of the diameter and number of endocardial vegetations in infective endocarditis was analyzed. Results: Compared to the control group,children in the observation group had lower values for Holter ECG parameters such as the standard deviation of normal R-R intervals (SDNN),root mean square difference of adjacent R-R intervals (rMSSD),and the percentage of R-R intervals with a standard deviation greater than 50ms (PNN50) in different time periods (P<0.05).Additionally,children with advanced infection (12h and 24h) had lower SDNN,rMSSD,and PNN50 levels than those with early infection (P<0.05).Furthermore,children with advanced infection exhibited higher serum levels of CRP,IL-6,and cTnI compared to children with early infection (P<0.05).The diameter and quantity of endocardial vegetations in children with advanced infection were lower than in those with early infection.The combined diagnosis of SDNN,rMSSD,CRP,IL-6,cTnI,and the size and quantity of vegetations demonstrated a high diagnostic value for infective endocarditis. Conclusion: Different time period parameters in pediatric Holter electrocardiography,as well as serum markers such as CRP,IL-6,and cTnI,along with the diameter and quantity of endocardial vegetations,have high diagnostic value in the context of infective endocarditis.This information provides valuable guidance for the early prevention and treatment of infective endocarditis.

Key words： Pediatric holter electrocardiogram Parameters of different time periods Infectious endocarditis Serum CRP Serum IL-6

基金资助:河北省承德市科学技术研究与发展计划项目,(编号:201704B003)

通讯作者: 许宏伟

引用本文:

刘蕾, 赵宏伟, 许宏伟. 小儿动态心电图不同时段参数与感染性心内膜炎赘生物的直径与数量的相关性[J]. 河北医学, 2023, 29(11): 1882-1886.
LIU Lei, et al. Correlation of Parameters at Different Time Periods in Pediatric Holter Electrocardiography with the Diameter and Quantity of Infective Endocarditis Vegetations. HeBei Med, 2023, 29(11): 1882-1886.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.11.024 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I11/1882

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