血清cTnI对VMC诊断及预后价值的研究(英文)

Value of serum cardiac troponin I in diagnosis and prognosis of viral myocarditis

目的研究病毒性心肌炎(VMC)时血清心肌肌钙蛋白I(cTnI)升高在其诊断及预后中的价值。方法采用化学发光酶免分析定量检测法、免疫抑制法、ELISA法分别进行cTnI,CK-MB病毒抗体检测。结果140例临床诊断VMC患者血清cTnI值为(0.23±0.37)ng/ml,与对照组(0.0 ng/ml)比较显著增高P<0.01。其中89例患者血清cTnI值升高,阳性率63.57%,明显高于CK-MB阳性率27.14%,P<0.01。动态观察组68例cTnI升高者,1个月转阴率76.47%,2个月转阴率94.12%,半年时间内全部转阴。12例重症患者血清cTnI全部升高,其值为(0.53±0.36)ng/ml,并且转阴时间长,大多超过1个月。140例VMC患者中,柯萨奇病毒抗体IgM 阳性者中cTnI阳性率72.55%,显著高于柯萨奇病毒抗体IgM阳性者中阳性率49.06%,二者比较有显著性差异,P<0.01。结论VMC患者血清升高是诊断VMC患者心肌损伤的客观依据,具有高度的特异性和敏感性,诊断时间窗长,对VMC的诊断及预后具有重要意义。

Objective: To explore the value of serum cardiac troponin I (cTnI) raised in diagnostic and prognostic of viral myocarditis (VMC). Methods: Chemiluminescent immunometric assay and Immunosupressive assay were used to qualitatively detect cTnI and MB isoenzyme of creatine kinase (CK-MB). ELISA test was used to quantitatively detect the anti-body of virus. Results: The average of serum cTnI in 140 patients was (0.23±0.37) ng/ml. It was higher than that of control group (0.0 ng/ml), P <0.01. The level of cTnI in 89 of 140 patients had increased, positive rate (63.57%) was higher than that of CK-MB (27.14%), P <0.01. 68 patients were dynamic observed. At the point of a month, the rate of cTnI turning to be in normal range was 76.47%, 94.12% at 2 months and 100% at 6 months. The cTnI had increased in 12 critical patients (0.53±0.36) ng/ml, the time of cTnI turning negative lasted longer and exceeded 1 month in major patients. The cTnI positive rate in the patients with IgM antibody of Coxackie virus was 72.55% and greater than the patients with that of IgG(49.06%). Conclusions: Elevation of serum cTnI will provide objective basis for the presence of myocardial injury in VMC patients. cTnI is a highly sensitive and specific marker and it appears to last longer. The detection of cTnI has great importance to diagnosis and prognosis of VMC.