| Objective: To explore the impact of severe pneumonia in children on cardiac function, by observing CK-MB, EF, E/A ratio, and pulmonary arterial pressure, and comparing the clinical effect of deslanoside and metoprolol treating childhood pneumonia with heart failure.Method:We study the children diagnosed with pneumonia in our hospital from January to December in 2008, and chose forty randomly as object. They were divided into two groups, heart failure group(HF group, n=20) and non-heart failure(non-HF group, n=20). The twenty patients in HF group were divided into two groups, deslanoside group(n=10) and metoprolol group(n=10). Among the forty patients, boys were twenty-three(57.5%), girls were seventeen(42.5%). In the HF group, boys were twelve(60%), girls were eight(40%). In the non-HF group, boys were eleven(55%), girls were nine(45%). In the deslanoside group, boys were six, girls were four, and the metoprolol group too. The criteria for pneumonia is that, (1)Symptoms(fever, cough, short of breath) (2)Signs(medium and fine crackles) (3) Assistant examination(exudation on chest X-rays). The criteria for pneumonia with heart failure in children is that, (1) Respiratory rate is more than sixty per minute. (2) Heart rate is more than one hundred and eighty per minute. (3) Dysphoria, cyanosis, pale, capillary refilling time delayed. (4) Low heart tones, gallop rhythm, distension of jugular vein. (5) The liver increase rapidly. (6) Little or no urine, edema of face, eyelid and lower limb. The patient would be diagnosed with heart failure if he or she accord with the front five items. It is not our object if the patient has primary heart disease such as congenital heart disease, arrhythmia, cardiogenic shock, infective endocarditis, myocarditis, cardiomyopathy, pericarditis, etc. Venous blood samples were collected in the morning after the patients were admitted to the hospital. It was taken to biochemical laboratory to measure the cardiac enzymes. The value of CK-MB was recorded. The patients also have the echocardiography examination by the same doctor. The EF value, E/A ratio and the pulmonary artery pressure were recorded. The heart rate of the patients in HF group were monitored by the electrocardiogram monitor. The date was recorded when the heart failure was corrected in deslanoside group and metoprolol group. The data were analyzed by spss16.0 and expressed by mean + standard deviation. The difference between two groups is analyzed by T-test. The value of p<0.05 was regarded as statistical significance.Results:(1)the change of CK-MBThe value of CK-MB is 13.90±6.79U/L in non-HF group, and 19.07±7.19U/L in HF group. There are significant differences between two groups(p<0.05). The value of CK-MB in HF group is higher than non-HF group.(2)the change of EF valueThe value of EF is 67.96±5.76(%)in non-HF group and 68.81±5.77 ( % ) in HF group. There are no significant differences between two groups(p>0.05). The values of EF are no significant differences between non-HF group and HF group.(3)the change of E/A ratioThe ratio of E/A is 1.53±0.35 in non-HF group and 1.42±0.30 in HF group. There are no significant differences between two groups(p>0.05). The ratios of E/A are no significant differences between non-HF group and HF group.(4)the effect of deslanoside and metoprololThe date to correct heart failure is 4.80±2.04 days in deslanoside group and 4.50±1.72 days in metoprolol group. There are no significant differences between two groups(p>0.05). The date to correct heart failure are no significant differences between deslanoside group and metoprolol group.(5)pulmonary hypertensionThere is no pulmonary hypertension in non-HF group or HF group.Conclusion:1. Non-severe pneumonia in children only affect the respiratory system itself, but severe pneumonia can damage the myocardial cell and make the CK-MB arise. 2. The severe pneumonia in children do not affect the pump function of heart, though it can damage the myocardial cell.3. Metoprolol can also improve the symptom of childhood pneumonia with heart failure as deslanoside.
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