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중증 기관지 천식 환아의 치료중 혈청 CPK - MB isoenzyme 활성도에 관한 연구
이은영(Eun Young Yi),송영호(Young Ho Song),이재욱(Jae Uk Yi),강임주(Im Ju Kang) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 1995 소아알레르기 및 호흡기학회지 Vol.5 No.2
N/A This study was performed to observe transient myocardial ischemia evaluated by ST-T wave change in ECG and CPK-MB isoenzyme activity during the treatment with intravenous corticosteroid and isoproterenol in severe childhood bronchial asthma. The children admitted to pediatric intensive care unit due to severe bronchial asthma from Jan, 1992 to Jun, 1993 were divided into 4 groups; Group A received nebulized albuterol and continuous intravenous infusion of theophylline, Group B received continuous intravenous infusion of both theophylline and terbutaline, Group C received intravenous methylprednisolone in addition to the therapy of Group A or B, and Group D received intravenous isoproterenol in addition to the therapy of Group C, Arterial blood gas analysis, serum CPK-MB isoenzyme activity, ECG, arterial O₂saturation (SpO₂) were compared. Resuts were as following : 1) The severity of asthma was considerably related to the past history of infantile eczema and family history of allergy. 2) The CPK-MB isoenzyme activity was highest in group D (58.9 IU/L) followed by group C (36. 7 IU/L), A (24.5 IU/L), B (22.4 IU/L), so the CPK-MB isoenzyme elevation was consistent with the severity of asthma. 3) Pulmonary index score (PIS) and SpO₂was unrelated with CPK-MB isoenzyme elevation, but PaCO₂, acidosis (pH< 7.2) was considerably associated with CPK-MB isoenzyme elevation. 4) Past history of corticosteroid therapy was considerably related to the CPK-MB isoenzyme elevation. In conclusion, we should consider transient myocardial ischemic injury during the treatment of severe bronchial asthma with intravenous methylprednisolone or isoproterenol and it is necessary to evaluate ECG and CPK-MB isoenzyme activity in patients with the history of previous therapy of corticosteroid and with severe acidosis or hypercapnia.