血清心肌肌钙蛋白Ⅰ判断病毒性心肌炎炎性损伤及预后的探讨

The prognostic value of serum cardiac troponin-I in virus myocarditis

目的 :探讨心肌肌钙蛋白 I( c Tn I)判断急性病毒性心肌炎炎性损伤程度及预后。方法 :采用抗人 c Tn I单抗 ,应用酶联免疫法测定 5 2例急性病毒性心肌炎患者血清 c Tn I,同时作肌酸磷酸激酶及其同工酶 ( CK,CK-MB)检测 ,血清 c Tn I>7μg/ L为阳性。第 1次 c Tn I阳性者第 2次复查仍然阳性者归入 c Tn I持续阳性组 ( 18例 ) ,复查 c Tn I阴性者归入 c Tn I阴性组 ( 2 0例 )。结果 :c Tn I阴性组与 c Tn I持续阳性组临床症状好转率、心律失常治愈率比较均有极显著性差异 ( P <0 .0 1)。 c Tn I持续阳性组中 ,有 2例患者发展为心肌炎后心肌病。 5 2例急性病毒性心肌炎患者中第 1次检测 c Tn I有 38例患者 c Tn I阳性 ( 73.1% ) ,有 3例 CK- MB异常 ( 5 .8% )。c Tn I持续阳性组柯萨奇 B病毒中和抗体转阴率明显低于 c Tn I阴性组 ,两者比较 P <0 .0 5。结论 :c Tn

Objective:To investigate the prognostic value of serum cardiac troponin I(cTnI) in virus myocarditis.Method:The concentration of serum cTnI and CK,CK MB were simultaneously measured with monoclonal antibody to cTnI by ELISA method.38 from 52 cases were cTnI positive at first time.The 38 patients with acute virus myocarditis were divided into cTnI positive (n=18) and negative groups (n=20) while measured repeatedly in 3 months.Result:The recovery rate of arrhythmia and symptom improved rate were 33.3 % vs 70.0 % and 22.2 % vs 70.0 % respectively between the cTnI positive and negative groups and thereby showed significant statistically.38 ( 73.1 %) cases were cTnI positive while only 3( 5.8 %)showed CK MB positive among the total 52 cases from their first time test and there was significant difference of the positive rates between two methods(P< 0.01 ).Serum negative conversion rate of the neutralizing antibody to the coxsackie B was lower ( 33.3 %)in the cTnI positive group compared with the 69.2 % in the cTnI negative group.Conclusion:cTnI may indicate the severity of inflammatory injury from the virus myocarditis and predict the prognosis of the illness.