Abstract
BACKGROUND: Severe pneumonia complicated by myocardial damage is a serious condition in children, and early prediction and intervention are crucial for improving outcomes. To explore the clinical value of serum hyaluronic acid, procollagen III N-terminal propeptide, sST2, and cfDNA levels in predicting myocardial damage in children with severe pneumonia. METHODS: A case-control study was conducted on 140 children with severe pneumonia, divided into a control group (n=70) and a group with disease complicated by myocardial injury (n=70). Biomarker levels (hyaluronic acid, procollagen III, N-terminal propeptide levels, sST2, and cfDNA) were detected through biochemical analysis, and clinical outcomes were compared between the two groups. RESULTS: Logistic regression analysis identified hypoalbuminaemia, age <3 years, and elevated levels of serum hyaluronic acid, procollagen III N-terminal propeptide, sST2, and cfDNA as independent risk factors for myocardial damage. The AUC of these biomarkers in predicting myocardial injury ranged from 0.68 to 0.78, with sensitivities and specificities of 65-80%. The combined prediction AUC was 0.92, with a sensitivity of 87.6% and a specificity of 77%. The control group had lower serum NT-proBNP, CK, CK-MB, and C-reactive protein levels and better clinical outcomes than the myocardial injury group. CONCLUSIONS: Serum hyaluronic acid, procollagen III, NTproBNP, sST2, and cfDNA significantly predict severe pneumonia complicated by myocardial damage. Nursing strategies based on these biomarkers can effectively improve treatment outcomes, demonstrating significant clinical application value.