小儿病毒性心肌炎诊断中血清高敏C反应蛋白、肌酸激酶同工酶以及心肌肌钙蛋白Ⅰ联合检测的价值

The value of serum hypersensitive C-reactive protein,creatine kinase isoenzyme and cardiac troponin Ⅰ in the diagnosis of viral myocarditis in children

目的:分析小儿病毒性心肌炎诊断中血清高敏C反应蛋白(hs-CRP)、肌酸激酶同工酶(CK-MB)以及心肌肌钙蛋白I(c Tn I)联合检测的价值。方法:本研究选取了2016年5月至2017年5月,院内收治的35例病毒性心肌炎(VMC)患儿作为观察组,同期选取院内体检的35例健康儿童作为对照组,对比两组儿童的血清hs-CRP、CK-MB以及c Tn I数值,分析血清hs-CRP、CK-MB、c Tn I诊断VMC的敏感性、特异性及准确性。结果:观察组患儿的血清hs-CRP、CK-MB以及c Tn I数值均显著高于对照组(P<0.05);ROC曲线分析结果显示,在诊断VMC的敏感性、特异性、准确性、曲线下面积方面,hs-CRP数值以>3mg/L为临界值时分别为65.71%、71.43%、68.57%、0.603,CK-MB数值以>25U/L为临界值时分别为62.86%、68.57%、65.71%、0.589,c Tn I数值以>0.5μL/L为临界值时分别为60.00%、65.71%、62.86%、0.578,hs-CRP、CK-MB、c Tn I联合检测时分别为94.29%、91.43%、92.86%、0.901,血清hs-CRP、CK-MB、c Tn I联合检测均显著高于单独检测,各组相比差异有统计学意义(P<0.05)。结论:血清hs-CRP、CK-MB以及c Tn I的联合检测,在VMC患儿的临床诊断中发挥出了较好的诊断价值,可以有效提高临床诊断水平,宜广泛应用和推广。

Objective： To analyze the value of serum high-sensitivity C-reactive protein（ hs-CRP）,creatine kinase isoenzyme（ CK-MB） and cardiac troponin I（ c Tn I） in children with viral myocarditis. Methods： Thirty-five healthy children with viral nyocarditis（ VMC） were enrolled in our hospital from May 20 to May 2017,and 35 healthy children were selected as the control group. The levels of serum hs-CRP,CK-MB and c Tn I,the sensitivity,specificity and accuracy of serum hs-CRP,CK-MB and c Tn I for the diagnosis of VMC were analyzed. Results： The values of serum hs-CRPn CK-MB and c Tn I in the observation group were significantly higher than those in the control group（ P〈0. 05）. ROC curve analysis showed that,in the sensitivity,specificity,accuracy,area under the curve of diagnosis of VMC,the hs-CRP value to 3 mg/L for the critical value were 65. 71%,71. 43%,68. 57%,0. 603,CK-MB value to 25 U/L for the critical value were 62. 86%,68. 57%,65. 71%,0. 589,c Tn I value to 0. 5 μL/L for the critical value were 60%,65. 71%,62. 86%,0. 578,hs-CRP,CK-MB,c Tn I combined detection were 94. 29%,91. 43%,92. 86%,0. 901,and the combined detection of serum CK-MB,hs-CRP and c Tn I were significantly higher than those of their single detection,the groups was statistically significant difference（ P〈0. 05）. Conclusion： The combined detection of serum hs-CRP,CK-MB and c Tn I has a good diagnostic value in the clinical diagnosis of VMC,which can effec-tively improve the clinical diagnosis level and should be widely used and popularized.