心肌肌钙蛋白Ⅰ与肌酸激酶同功酶-MB在小儿心肌损害诊断中的应用

Application of Cardiac Troponin Ⅰ and Creatine Kinase Isoenzyme-MB in Diagnosis of Myocardial Damage in Children

目的探讨心肌肌钙蛋白Ⅰ(cardiac troponin I,c Tn I)与肌酸激酶同工酶-MB(creatine kinase isoenzyme-MB,CK-MB)在小儿肌损害临床诊断中的应用价值。方法选取2010年6月—2013年12月期间该院收治的急性心肌炎患儿90例为研究对象,并选择同期健康体检儿童85名为对照组,检测入院时、入院2周后患儿c Tnl、CK-MB水平,井进行两项指标的比较。结果观察组患儿的c Tnl水平为(0.24±0.08)ug/L,CK-MB为(0.44±0.19)mmol/(s·L),明显高于对照组(P<0.05);观察组检出率为80.0%对照组为49.41%,差异有统计学意义(P<0.05);住院2周后,观察组CK-MB水平为(0.27±0.10)mmol/(s·L),c Tnl水平为(0.13±0.12)ug/L,仍高于对照组(P<0.05)。结论在小儿心肌炎的临床诊断上,心肌肌钙蛋白Ⅰ、肌酸激酶同工酶-MB均为敏感性该指标,不过c Tnl对心肌损害特异性、敏感性均高于CK-MB,诊断时间窗也明显较宽,特异性显著高于心肌酶学检查。

Objective To discuss the application value of Cardiac Troponin I and Creatine kinase isoenzyme - MB in diagnosis of myocardial damage in children. Methods 90 cases of children with acute myocarditis admitted and treated in our hospital from June 2010 to December 2013 were selected as the research objects, and 85 cases of healthy physical examination children at the same period were selected as the control group, and the cTnl and CK-MB levels were tested at admission and in 2 weeks after admission, and the two indexes were compared. Results The cTnl and CK-MB levels in the observation group were respectively（0.24±0.08）ug/L and（0.04±0.01）mmol/（s·L）, which were obviously higher than those in the control group （P〈0.05）; In the observation group and the Control, the test rate was respectively 80.00% and 49.41%, and the differences were obvious（P〈0.05）, and after 2-week hospitalization, the CK-MB level and cTnl level in the observation group were respectively（0.27±0.10）mmol/（s·L） and （0.13±0.12）ug/L, which were higher than those in the control group（P〈0.05）. Conclusion In clinical diagnosis of myocardial damage in children, the cardiac troponin I and creatine kinase isoenzyme -MB are sensitive indicators, but the specificity and sensitivity of eTnl for myocardial damage are higher than CK-MB, and the diagnosis time window is obviously wider, and the specificity is obviously higher than the examination of cardiac enzymes.