3项生化指标在诊断小儿病毒性心肌炎中的临床意义

Clinical significance of NT-proBNP,cTnI and CK-MB in the diagnosis of viral myocarditis in children

目的探讨氨基末端脑利钠肽前体(NT-proBNP)、心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)3项生化指标在诊断以腹痛为突出表现的小儿病毒性心肌炎(VMC)中的临床意义。方法选择7例腹痛VMC患儿、33例以腹痛为突出表现同时有循环不稳定表现的非VMC患儿、40例健康儿童,测定其血清NT-proBNP、cTnI、CK-MB水平。结果腹痛VMC组NT-proBNP、cTnI及CK-MB水平明显高于腹痛非VMC组和健康对照组,差异有统计学意义(P<0.01)。腹痛VMC组与健康对照组CK-MB水平差异有统计学意义(P<0.01)。腹痛VMC患儿NT-proBNP灵敏度为100.00%,特异性为90.90%;cTnI灵敏度为71.40%,特异性为84.80%;CK-MB灵敏度为57.14%,特异性为39.40%。结论血清NT-proBNP、cTnI、CK-MB是诊断以腹痛为突出表现的VMC患儿的敏感指标。

Objective To explore the clinical significance of N-terminal pro-brain nitric peptide （NT-proB-NP） ,cardiac troponin I （cTnI） and isoenzyme of creatinkinase （CK-MB） in the diagnosis of viral myocarditis （VMC） in children with main symptoms of abdominal pain .Methods A total of 7 children with VMC and abdominal （VMC group） ,33 children without VMC but with symptoms of abdominal pain and unstable blood circulation （non-VMC group） ,and 40 healthy children （control group） were enrolled and detected for serum levels of NT-proBNP ,cTnI and CK-MB .Results Serum levels of NT-proBNP ,cTnI and CK-MB in VMC group were higher than non-VMC group and control group （P〈0 .01） .Serum level of CK-MB in non-VMc group was higher than control group （P〈0 .01） . The sensitivity and specificity of NT-proBNP for the diagnosis of VMC were 100 .0% and 90 .90% ,of cTnI were 71 .40% and 84 .80% ,and of CK-MB were 57 .14% and 39 .40% .Conclusion Serum NT-proBNP ,cTnI and CK-MB might be sensitive indicators for the diagnosis of VMC in children with main symptoms of abdominal pain .