血清心肌肌钙蛋白T在病毒性心肌炎诊断及预后影响研究

To Study the Influence of Serum Cardiac Troponin T in the Diagnosis and Prognosis Estimation in Patients with Viral Myocarditis

目的:探讨血清心肌肌钙蛋白T(cTnT)在病毒性心肌炎(VM)诊断及预后判断中的应用。方法:回顾性分析自2000～2004年采用酶联免疫测定法对126例不同病程的VM患者及60例正常者(正常组)检测血清cTnT及肌酸激酶-MB同工酶(CK-MB)。长期随访观察cTnT:采用超声心动图测定,观察心脏大小及心室功能变化。结果:VM患者cTnT的阳性率显著高于CK-MB。随着病程的延长,cTnT的阳性率降低;对照组全部阴性。随着入院时血清cTnT水平的由低至高,左室舒张末内径增大而射血分数降低。结论:cTnT是心肌细胞急性损伤的指标优于CK-MB。cTnT水平高低与患者心脏大小以及远期心室功能发展有关,对拟诊VM患者检测cTnT为VM的治疗转归和预后提供重要线索。

Objective： To determine the role of serum cardiae troponin T （ cTnT） in the diagnosis and prognosis estimation in patients with viral myocarditis. Method： A retrospective study was carried out 126 patients with viral myocarditis （VM） of different clinical duration and 60 healthy controls were examined for cTnT and creatine kinase isoenzyme MB （ CK - MB） by enzyme immuno so rbant assay by enzyme immnoh istochem icalmethod since from 2000 to 2004 in our hospital. Enlargment and function of the vent ricle were assessed by echocardiography. The level of cTnT and ventricular function were measured at follow up. Result： The positive rates of cTnT in VM group was significantly higher than that of CK - MB in the diagnosis of viral myocarditis, and had a direct correlation with the clinical stage. Control group were all negative. With the rise of cTnI level, the left vent ricular diastolic diameter （LVDd） showed increase, but ejection fraction （EF） showed reduction at follow up. Conclusion： As a marker of myocyte acute injury, serum cTnT is superior to CK - MB. The level of serum cTnT is associated with the development of deterioration of vent ricular function. Measure of cTnT could increase sensitivity of diagnosis for the patients with clinically suspected myocardit is and provide important clue for treatment and prognosis of the disease.