Investigation on risk factors of acute myocardial damage caused by childhood sepsis in Qinghai area and preventive measures / 公共卫生与预防医学

ABSTRACT

Objective To preliminarily analyze the acute myocardial damage and important risk factors caused by sepsis in children in Qinghai, and analyze and discuss preventive measures on the basis of the foregoing. Methods The study selected 385 children with sepsis in our hospital from January 2016 to December 2020 and included 158 children with acute myocardial damage caused by sepsis (case group), and the remaining 227 cases (control group) were not seen Myocardial damage. The study collects basic information such as sociodemographic information of all children, and collects serum troponin I (cTnI) and CK-MB levels (determined by chemiluminescence method); as well as serum CRP levels and PCT levels. To compare and analyze the levels of related indexes in children with myocardial damage, and the differences from those in the control group. Then analyze and see the risk factors that are potentially associated with acute myocardial damage. Use SPSS statistical software package to analyze the data. cTnI enzyme-labeled immunoassay assay, reagents are provided by Nanjing Jidan Biotechnology Co., Ltd.; medicine is (0.00~0.01) μg/mL, cTnI level normal group (≤0.01 μg/mL) and cTnI level elevated group ( > 0.01 μg/mL) ); CK-MB>5 ng/mL is the positive standard for myocardial muscle injury; CRP medical reference value < 8mg/L, PCT< 0.1 ng/mL; CRP is detected by the turbidimetric method, and the instruments and reagents are manufactured by German Deling BNⅡ specific protein analyzer and original matching reagents. Pediatric Critical Case Score (PCIS) and Pediatric Death Risk Factor Score (PRISM Ⅲ) (evaluate twice, take the lowest value). Results In this study, the majority of male children were male, and the proportion of children with active myocardial damage had a higher proportion of low-grade fever. At the same time, the disease was more severe than the control group. It can be seen that the PCIS score is lower and the PRISM Ⅲ is higher. The difference is statistically significant. (P<0.05). The serum troponin I (cTnI), CK-MB, CRP, and PCT levels in the case group were significantly higher than those in the control group, and the differences were statistically significant (P<0.05); the serum albumin levels were significantly lower than those in the control group, and the differences were statistically significant Scientific significance (P<0.05); the risk factor analysis was carried out with the presence of myocardial damage as the dependent variable, and the potential influencing factors as the independent variables (social demographic factors, basic conditions of hospitalization, levels of indicators related to myocardial damage, etc.). Including single factor analysis (adjustment for potential confounding factors) and multivariate analysis. The results showed that increased age, low fever, increased PCT, low albumin level ( ≤ 25g/L), and increased PRISMⅢ were risk factors for myocardial damage (P<0.05). Conclusions Acute myocardial damage caused by sepsis in children with sepsis can be seen in male children, and children with active myocardial damage have a higher proportion of low-grade fever. At the same time, the condition is more severe than that of the control group. It can be seen that the PCIS score is higher. Low, higher PRISMⅢ, and other significant characteristics; analysis of potential influencing factors suggests that increased age, low fever, increased PCT, low albumin levels, and increased PRISMⅢ are positively correlated with the increased risk of acute myocardial damage in children. Therefore, it is planned to be clinically 1. Pay attention to older children with low fever and more critically ill children; 2. Detect or monitor the levels of PCT and albumin in children to early warn the occurrence of myocardial damage; carry out necessary and timely warning and prevention.