川崎病患儿血清心肌肌钙蛋白Ⅰ变化及临床意义

Changes of Serum Cardiac Troponin I and it's Clinical Significance in Children with Kawasaki Disease

目的 :探讨心肌肌钙蛋白Ⅰ (cTnI)在川崎病急性期心肌损伤的诊断价值。方法 :检测川崎病 (KD)组 (n =5 6 )及对照组(n =2 0 )患儿血清cTnI、肌酸激酶 (CK)、肌酸激酶同功酶 (CK -MB)、乳酸脱氢酶 (LDH)浓度。结果 :KD组与对照组血清CK、LDH浓度无显著差别 (P >0 .0 5 ) ,而血清cTnI、CK -MB浓度明显高于对照组水平 (P <0 .0 0 1)。在诊断KD患儿急性期心肌损伤上cTnI优于CK -MB(P <0 .0 5 )。结论 :cTnI与CK -MB对KD患儿急性期心肌损伤有诊断价值 ;与CK -MB比较 ,cTnI具有高度特异性、灵敏度 ,指导早期IVIG治疗 ,从而减少KD患儿心血管并发症的发生。

Objective: To explore the diagnosis significance of serum cardiac troponin I (cTnI) for the detection of myocardial injury in children with Kawasaki disease (KD) in acute stage. Methods: The levels of serum cTnI, creatine kinase (CK), creatine kinase isoenzyme (CK-MB), lactic dehydrogenase (LDH) were determined in 56 children with KD and 20 controlled children without heart diseuse, respectively. Results: The levels of serum cTnI and CK-MB in the KD group were significantly higher than those in the control group ( P <0.001), while no obviously differences of CK?LDH were noticed between two groups ( P >0.05), cTnI was more sensitively comparing to CK-MB for diagnosis of myocardial injury ( P <0.05) in acute stage. Conclusion: It is concluded that the determination of cTnI and CK-MB will be available for the diagnosis of myocardial injury in children with KD in acute stage, and the determination of cTnI is more sensitivity and specificity comparing to CK-MB, guiding IVIG therapy in early stage and the cardiovascular complication of the children with KD can be reduced.