肌钙蛋白I对小儿心肌炎诊断及与酶学对比研究

Diagnosis of Myocardial Troponin I on Infantile Myocardicis and Comparison with Myocardial Enzyme

目的评估血清心肌肌钙蛋白Ⅰ（cTnⅠ）对小儿心肌炎的诊断价值，并与肌酸激酶（CK）及其同功酶MB（CK-MB）进行对比研究．方法全自动生化分析仪对cTnⅠ，CK及CK—MB进行定量检测．结果1）心肌炎组cTnI，CK及CK-MB均明显高于正常对照组（P〈0．001）．cTnⅠ升高38例，占76％；CK升高21例，占42％；CK-MB升高25例，占50％．cTnⅠ与CK，CK-MB呈正相关关系．2）治疗2周后，cTnⅠ与对照组比较有显著性差异（P〈0．001），CK及CK-MB与对照组无显著性差异（P〉0．05）．3）心肌炎组22例ST-T改变患儿测cTnⅠ升高20例（91％），CK升高8例（37％），CK-MB升高6例（27％）．结论cTnⅠ及CK，CK-MB对小儿心肌炎的诊断均较敏感，其中cTnT对心肌损害的敏感性及特异性均高于CK和CK—MB．cTnⅠ诊断时间窗宽于CK，CK-MB，特异性也高于心肌酶学检查．

Objective To evaluate the diagnostic value of cardiac troponin Ⅰ （cTnⅠ） in the pediatric myocarditis and make a comparative study among cTnⅠ, creatinekinase （CK） and MB isoenzyme of creatinekinase（CK-MB）. Methods Automatic biochemical analysis was used to measure cTnⅠ, CKand CK-MB. Results 1 ）cTnⅠ, CK and CK-MB in myocarditis group were remarkably higher than those of normal control group（P 〈0.001 ）. cTnⅠ increased in 38 cases（76% ） , CK increased in 21 cases（42% ）, CK-MB increased in 25 cases（50% ）. cTnI, CK and CK-MB showed a positive correlation. 2）After two weeks treatment, cTnI in myocarditis group was significantly different from that of control group（ P 〈 0.001 ） , but CK and CK-MB were not significantly different from that of control group （ P 〉 0.05 ）. 3 ） In 22 myocarditis children with ST-T changes, cTnI increased in 20 cases（91% ） , CK increased in 8 cases（37% ） and CK-MB increased in 6 cases（27% ）. Conclusion cTnⅠ, CK and CK-MB are sensitive to the diagnosis of pediatric myocarditis. In addition, cTnI has a higher sensitivity and specificity than CK and CK-MB. The diagnostic time window of cTnⅠ is wider than that of CK and CK-MB.