抗心肌抗体在小儿病毒性心肌炎诊断中的价值及意义

The values of anti-heart autoantibodies in the diagnosis of viral myocarditis in children

目的:分析病毒性心肌炎(VMC)患儿抗心肌抗体(AHA)的检测结果,明确AHA在小儿VMC诊断中的作用。方法:采用前瞻性分析方法,入选62例VMC患儿为VMC组,同期46例疑似VMC患儿为疑似VMC组,20名健康儿童设为对照组,采用酶联免疫吸附法对各组4种AHA[抗心肌线粒体ADP/ATP载体蛋白(ANT)抗体、抗β1-受体抗体、抗M2胆碱能(M2)受体抗体、抗肌球蛋白重链(MHC)抗体]的结果进行分析和比较。结果:VMC组4种AHA的阳性率均高于对照组,差异有显著统计学意义(P<0.01),疑似VMC组4种AHA的阳性率亦高于对照组,差异有统计学意义(P<0.05)。VMC组与疑似VMC组间差异有统计学意义(P<0.05)。抗ANT抗体、抗β1-受体抗体、抗M2受体抗体、抗MHC抗体在VMC患儿中检测的灵敏度分别为91.9%、93.5%、90.3%、93.5%,特异度分别为85%、80%、85%、85%。11例暴发性心肌炎患儿4种AHA的阳性率分别为81.8%、90.9%、81.8%、81.8%。结论:AHA对小儿VMC的诊断具有较高的特异性和敏感性,检测结果与临床诊断高度一致,临床上可为VMC的诊断及免疫治疗提供依据。

Objective：To explore the diagnostic and treatment value of anti-heart antibody in children with viral myocarditis.Method：Using retrospective analysis method,62 cases children with viral myocarditis were assigned to myocarditis group,46 cases of suspected viral myocarditis were set up in the suspected myocarditis group during the same period and 20 healthy children were enrolled in the control group.Enzyme-linked immunosorbent method were used to check four kinds of anti-heart autoantibodies（AHA）in myocardiatis for each group and all results were compared.Result：The four AHA positive rates of myocarditis patients were higher than those in the control group with significant difference（P〈0.01）.The four AHA positive rates of suspected myocarditis group were also higher than those in the control group（P〈0.05）.Conclusion：The anti-heart autoantibodies can be taken as specific markers of diagnosis for children with viral myocarditis.