Application Value of Serum Cardiac Troponin T, Brain Natriuretic Peptide Levels and Electrocardiogram Changes in the Treatment and Prognosis Evaluation of Severe Pneumonia in Children

Figures & data

Figure 1 Case Flow Chart.

Table 1 Comparison of Serum cTnT and BNP Levels Before and After Treatment Between Two Groups

Variate	Mild Group (n=120)	Severe Group (n=120)	t/χ^2	P
Age (age)	5.83±1.08	5.76±1.12	0.493	0.623
Gender (n, %)
Male	74 (61.67)	69 (57.50)	0.433	0.511
Female	46 (38.33)	51 (42.50)
Pathogen class (n, %)
Bacteria	41 (34.17)	42 (35.00)	0.327	0.849
Virus	36 (30.33)	39 (32.50)
Mycoplasma	43 (35.83)	39 (32.50)
K^+ (mmol/L)	3.54±1.02	3.63±1.05	0.673	0.501
TC (mmol/L)	4.74±1.19	4.83±1.25	0.571	0.568
CRP (ng/L)	16.54±3.23	21.58±3.46	11.664	0.000
WBC (×10^9/L)	12.96±3.16	13.773±3.25	1.957	0.051

Table 2 Comparison of Serum cTnT and BNP Levels Between the Two Groups Before and After Treatment

Group	n	cTnT (ng/mL)				BNP (pg/mL)
		Before Treatment	After Treatment	t	P	Before Treatment	After Treatment	t	P
Mild group	120	246.53±35.47	161.24±21.38	51.819	0.000	357.64±46.28	214.32±22.58	64.492	0.000
Severe group	120	328.64±39.25	178.26±24.57	82.902	0.000	486.59±53.25	251.79±26.54	92.198	0.000
t		17.002	5.724			20.022	11.779
P		0.000	0.000			0.000	0.000

Abbreviations: cTnT, Cardiac troponin T; BNP, Brain Natriuretic Peptide.

Table 3 Comparison of ECG Changes Before and After Treatment Between the Two Groups [n (%)]

Variate	Mild Group (n=120)				Severe Group (n=120)
	Before Treatment	After Treatment	χ^2	P	Before Treatment	After Treatment	χ^2	P
Nodal tachycardia	26 (21.67)	5 (4.17)^a	16.336	0.000	20 (16.67)	7 (5.83)	7.053	0.008
Sinus bradycardia	3 (2.50)	0 (0.00)	1.350	0.245	3 (2.50)	1 (0.83)	0.254	0.614
Paroxysmal supraventricular tachycardia	2 (1.67)	0 (0.00)	0.504	0.478	0 (0.00)	0 (0.00)	0.000	1.000
Bundle-branch heart-block	5 (4.17)	0 (0.00)	3.628	0.071	14 (11.67)^a	7 (5.83)^b	2.557	0.110
P wave height tip	0 (0.00)	1 (0.83)	0.000	1.000	13 (10.83)^a	3 (2.50)	6.696	0.010
Prolonged PR or QTinterval	0 (0.00)	0 (0.00)	0.000	1.000	3 (2.50)	1 (0.83)	0.254	0.614
ST segment elevation or depression	6 (5.00)	2 (1.67)	1.164	0.281	7 (5.83)	2 (1.67)	1.847	0.174
T-wave low or inverted	0 (0.00)	0 (0.00)	0.000	1.000	4 (3.33)	3 (2.50)	0.000	1.000
Atrial premature beats	15 (12.50)	3 (2.50)	8.649	0.003	12 (10.00)	1 (0.83)	9.841	0.002
Ventricular premature beat	2 (1.67)	0 (0.00)	0.504	0.478	6 (5.00)	2 (1.67)	1.164	0.281
Ventricular tachycardia	0 (0.00)	0 (0.00)	0.000	1.000	4 (3.33)	2 (1.67)	0.171	0.679
Total	49 (40.83)	8 (6.67)	38.677	0.000	71 (59.17)^a	23 (19.17)^b	40.291	0.000

Notes: Compared with the mild group before treatment, ^aP<0.05; Compared with the mild group after treatment, ^bP was <0.05.

Table 4 Comparison of Serum cTnT and BNP Levels in Patients with Severe Pneumonia with Different Prognosis Before and After Treatment

Group	n	cTnT (ng/mL)				BNP (pg/mL)
		Before Treatment	After Treatment	t	p	Before Treatment	After Treatment	t	p
Survival group	78	324.86±37.64	164.84±24.93	74.398	0.000	481.16±51.32	236.58±28.74	81.879	0.000
Death group	42	335.66±42.71	203.18±27.25	39.620	0.000	496.67±52.43	280.04±32.69	52.665	0.000
t		1.429	7.777			1.567	7.526
P		0.156	0.000			0.120	0.000

Abbreviations: cTnT, Cardiac troponin T; BNP, Brain Natriuretic Peptide.

Table 5 Comparison of ECG Changes in Patients with Severe Pneumonia with Different Prognosis Before and After Treatment [n (%)]

Variate	Survival Group (n=78)				Death Group (n=42)
	Before Treatment	After Treatment	χ^2	P	Before Treatment	After Treatment	χ^2	P
Nodal tachycardia	12 (15.38)	3 (3.85)	5.974	0.015	8 (19.05)	4 (9.52)	1.556	0.212
Sinus bradycardia	1 (1.28)	0 (0.00)	0.000	1.000	2 (4.76)	1 (2.38)	0.000	1.000
Bundle-branch heart-block	8 (10.26)	1 (1.28)	4.245	0.039	6 (14.29)	5 (11.90)^b	0.105	0.746
P wave height tip	9 (11.54)	1 (1.28)	6.838	0.009	4 (9.52)	2 (4.76)	0.179	0.672
Prolonged PR or QTinterval	1 (1.28)	0 (0.00)	0.000	1.000	2 (4.76)	1 (2.38)	0.000	1.000
ST segment elevation or depression	4 (5.13)	0 (0.00)	2.039	0.129	3 (7.14)	2 (4.76)	0.000	1.000
T-wave low or inverted	2 (2.56)	0 (0.00)	0.506	0.477	2 (4.76)	4 (9.52) ^b	0179	0.672
Atrial premature beats	8 (10.26)	0 (0.00)	6.456	0.011	4 (9.52)	1 (2.38)	0.851	0.356
Ventricular premature beat	4 (5.13)	1 (1.28)	0.826	0.363	2 (4.76)	1 (2.38)	0.000	1.000
Ventricular tachycardia	3 (3.85)	0 (0.00)	1.359	0.244	1 (2.38)	2 (4.76)	0000	1.0007
Total	43 (55.13)	5 (6.41)	43.454	0.000	26 (61.90)	15 (35.71)^b	5.765	0.016

Notes: Compared with pre-treatment survival group, ^aP<0.05; Compared with the survival group after treatment; ^bP<0.05.

Table 6 Multivariate Logistic Regression Analysis of Prognostic Factors in Children with Pneumonia

Affecting Factors	β	SE	Wald	P	OR	95% CI
cTnT	1.179	0.347	11.544	0.001	3.251	1.647~6.418
BNP	1.245	0.386	10.403	0.001	3.473	1.630~7.401
Bundle-branch heart-block	0.935	0.325	8.268	0.004	2.546	1.347~4.814
T-wave low or inverted	0.602	0.223	7.277	0.007	1.825	1.179~2.825

Abbreviations: cTnT, Cardiac troponin T; BNP, Brain Natriuretic Peptide.

Table 7 Prognostic Value of Serum cTnT and BNP Levels in Children with Severe Pneumonia After Treatment

Variable	AUC	Cutoff value	95% CI	Sensibility(%)	Specificity(%)	Youden Index
cTnT	0.819	180.89 ng/mL	0.739~0.884	78.57	75.64	0.542
ACTA	0.774	261.00 pg/mL	0.688~0.845	71.43	78.21	0.496
Combination of the two	0.884	–	0.812~0.935	88.10	74.36	0.625

Figure 2 ROC Curves for Predicting the Prognosis of Patients with Severe Pneumonia Using Serum cTnT and BNP Levels After Treatment.