兰州市小于18岁健康儿童心肌酶谱参考值趋势性分析

Trend Analysis of Reference Value of Myocardial Enzymes in Healthy Children under 18 Years Old in Lanzhou

目的通过对兰州市区婴幼儿、中小学生进行体检,检测10 d^18岁健康儿童心肌酶谱参考值,分析健康儿童与成人心肌酶谱参考值的趋势性差异,确定本地区健康儿童心肌酶谱的正常值范围。方法将234名10 d^18岁健康儿童分为婴幼儿组、学龄前组、学龄组及青少年组。男118例,女116例。采集其外周静脉血3 mL,用速率法测定其血清中AST、LDH、α-羟丁酸脱氢酶(α-HBDH)、CK、CK-MB水平,并对检测结果进行统计学分析。结果 (1)4个年龄组血清中AST、LDH、a-HBDH、CK、CK-MB水平均较成人高,年龄越小,水平越高,随着年龄的增长,其水平逐渐接近成人。(2)这4个年龄组的指标测值与成人组比较,婴幼儿组、学龄前组及学龄组有统计学意义(Pa<0.01);青少年组无统计学意义(P>0.05)。(3)各年龄组男、女童血清心肌酶谱水平比较差异均无统计学意义(Pa>0.05)。结论 <18岁健康儿童各年龄组心肌酶谱参考值有随年龄增长逐渐递减的趋势,各项指标高于成人参考值水平,故在诊断儿童病毒性心肌炎时应参考本地区儿童心肌酶谱的正常值。

Objective Through medical examination in urban infants,children,and students in the primary and the middle school,the reference values of myocardial enzymes of healthy children under 18 years old were determined,and the difference was analyzed between the healthy children and the adults to determine the normal range of the myocardial enzymes of healthy children in local region.Methods A total of 234 healthy children were divided into 4 groups： infant group,pre-school group,school age group and youth group.There were 118 boys and 116 girls.The venous blood was collected,and the levels of serum aspartate aminotransferase（AST）,lactate dehydrogenase（LDH）,α-hydroxybutyrate dehydrogenase（α-HBDH）,creatine kinase（CK） and creatine kinase isoenzyme（CK-MB） were determined.Test data in 4 groups were statistically analyzed.Results 1.The serum of AST,LDH,α-HBDH,CK and CK-MB levels in each age group were higher than those of the adults.The teenagers had the higher levels.And the data were gradually approaching the level of adults while they were growing up.2.The indicator values in the infant group,the pre-school group and the school-age group had statistically significant differences compared with adult group（Pa0.01）.There was no significant difference in the teenager group（P0.05）.3.Enzyme myocardial values between male and female in all age groups had no statistically significant differences（Pa0.05）.Conclusions The levels of myocardial enzymes of healthy children under 18 years old in each age group have progressively decreasing while they were growing up.The reference values are more significant in children than those in adult;the myocardial enzymes in normal children before diagnosis of viral myocarditis should be refered to the normal enzyme myocardial values in region.