肌钙蛋白T在病毒性心肌炎和扩张型心肌病的临床评价

Clinical evaluation of troponin T in viral myocarditis and dilated cardiomyopathy

目的:评价心肌特异性肌钙蛋白T（cTnT）对病毒性心肌炎（VMC）和扩张型心肌病（DCM）心肌损伤的诊断价值．方法：采用一步夹心法对76例VMC和25例DCM患者进行cTnT检测，同时检测肌酸激酶同功酶（CK－MB）和乳酸脱氢酶同功酶（LDi）。结果：应用运算特征曲线确定心肌损伤测定值为cTnT≥0．12μg／L，其诊断的特异性为92．7％，敏感性为85．5％。与CK－MB和LDi比较，cTnT诊断VMC和DCM心肌损伤的敏感性和特异性均优于CK－MB和LDi，cTnT检测时间窗也比CK－MB和LDi更长。结论：cTnT可作为VMC和DCM心肌损伤诊断的主要方法，有可能取代CK－MB和LDi检测。

Objective: To evaluate the diagnostic value of cardiac troponin T(cTnT)in myocardial injury of viral myocarditis (VMC)and dilated cardiomyopathy (DMC ). Method:Serum levels ofcTnT were assayed by the one-step sandwich assay in 76 patients with VCM and 25 patients withDCM. Concentrations of isoenzyme of creatine kinase (CK-MB)and lactic dehydrogenase (LDi )were measured at the same time. Results: The serum level of cTnT to determine myocardial injurywas above 0. 12μg/L according to the receiver operator characteristic curve, the specificity was92. 7% and sensitivity was 85. 5% in the diagnosis of myocardial injury of VMC. The specificityand sensitivity of cTnT is higher than that of CK-MB and LDi, the assay window time of cTnT isalso longer than that of CK-MB and LDi in diagnosis of myocardial injury in VMC and DCM. Conclusion: The cTnT assay may become one of the major method to determine myocardial injury,it ispossible of replacing CK-MB and LDi assay for detecting myocardial damage in VMC and DCM.