The Clinical Study On Myocardial Injury In Non Cardiogenic Critically IL1Children

Objective:To know about the incidence of myocardial injury in noncardiogenic critically ill children.Explore the impact on disease progressionand prognosis of cardial troponin I (cTnl) and creatine kinase isoenzyme MB(CK-MB),to provide guidance for early treatment.Methods: Retrospective study of292consecutive patients with noncardiogenic disease admitted to the pediatric intensive care unit(PICU) inChildren’s Hospital of Chongqing Medical Univercity from August2012toJuly2013.Collect the serum cTnI and CK-MB level Within24hours ofadmission.All patients are firstly divided into two groups:myocardialmarkers normal group and myocardial markers abnormal group.Secondlyaccording to cTnI and CK-MB level divided myocardial markers abnormalgroup into cTnI elevated group,CK-MB elevated group,single elevatedgroup (cTnI or CK-MB elevated) and double elevated group (cTnI andCK-MB elevated). Compare the differences between groups in clinicalindicators and analysis the relationship between myocardial markers（cTnI,CK-MB）and the prognosis.Results:The incidence of myocardial injury in non cardiogeniccritically ill children is55.1%(161/292cases).Myocardial markers normal group is significant difference from myocardial markers abnormal group anddouble elevated group in clinical indicators,like low heartsound,hypotension,shock,the use of vasoactive agents,heart failure,respiratory failure,mortality,MODS and PCIS(P＜0.05).Only the prognosisis significant different between cardiac markers normal group and singleelevated group (P＜0.017).Compared to single elevated group,doubleelevated group is significant different in hypotension,shock,the use ofvasoactive agents,heart failure, mortality,MODS and PCIS(P＜0.017).Theprognosis has significant negative correlation with the level of cTnI andCK-MB.Conclusion: There is high incidence of myocardial injury in noncardiogenic critically ill children. CK-MB, cTnI are both suitable for earlydiagnosis and follow-up of myocardial injury in non cardiogenic critically illchildren and combined detection makes more significance.Both cTnl andCK-MB elevated patients are worse, with increasing incidence ofhemodynamic changes, heart failure,MODS and higher mortality. Thehigher of cTnI and CK-MB value,the worse prognosis.