心肌肌钙蛋白Ⅰ与肌酸激酶同工酶在儿童心肌损害诊断中的比较

Comparison of cardiac troponin I with CK-MB in the diagnosis of myocardial injury in children

目的:了解各病理状况对心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)的影响,并比较其诊断价值。方法:对4组儿童进行血清cTnI、CK-MB测定。A组为健康儿童54例;B组为一般状况可的非心血管疾病患儿53例;C组为病情稳定的先天性心脏病患儿12例;D组为急性心肌炎患儿14例。结果:A组cTnI值均<0.25"g/mL,各年龄组之间差异无显著性,CK-MB升高1例(1.9%)。A、B、C组cTnI值之间差异无显著性。B组cTnI升高1例(1.9%),CK-MB升高9例(16.9%);C组cTnI均不升高,CK-MB升高1例(8.3%);D组cTnI升高11例(78.6%),平均值较A组显著增高(P<0.01)。结论:cTnI可用来诊断儿童心肌损害,无心血管系统受累的患儿cTnI值不升高,心血管系统以外的疾病可影响CK-MB值。

Objective To determine the impacts of various pathological changes on serum cardiac troponin I （cTnI） levels and ereatine kinase MB isoenzyme （CK-MB） activity and to compare the diagnostic values of cTnI with that of CK-MB. Methods Serum cTnI levels and CK-MB activity were measured in four groups of children. Group A included 54 healthy children as control. Group B ineluded 53 pediatric patients without cardiac diseases. Group C included 12 pediatric patients with stable congenital heart diseases. Group D included 14 pediatric patients with acute myocarditis. Results The cTnI levels were all less than 0.25 μg/mL in group A and there were no significant differences among the subgroups of different ages. CK-MB was increased in one patient （1.9%）. cTnI did not differ significantly among groups A, B, and C. One patient （1.9%） had elevated eTnI and nine patients （16.9%） had higher CK-MB in group B. No increase in cTnI occurred in group C whereas CK-MB was elevated in one patient （8.3%）. cTnl in group D was increased in 11 patients and its mean value was markedly higher than that in group A （P 〈 0.01 ）. Conclusion eTnI can be used to diagnose myocardial injury in children with a high specificity and sensitivity. No elevation in cTnI occurred in the children who have no cardiovascular diseases. CK-MB activity, however, can be affec, ted by other disorders besides cardiovascular diseases.