CgA、UⅡ、CK-MB水平变化与小儿病毒性心肌炎病情严重程度的关系研究

Relationship between changes of CgA, UⅡ and CK-MB levels and severity of myocarditis in children

目的探讨血清嗜铬粒蛋白A(CgA)、尾加压素Ⅱ(UⅡ)、肌酸激酶同工酶-MB在小儿病毒性心肌炎中的表达及意义。方法选取2015年1月至2018年1月在我院治疗的小儿病毒性心肌炎患儿98例(观察组),其中无心衰患儿23例,轻度心衰患儿33例,中度心衰25例,重度心衰17例,同时选取健康儿童100例作为对照组,检测血清CgA、UⅡ、CK-MB水平,同时给予超声心动图检查。结果观察组血清CgA和CK-MB分别为(963.29±104.33)ng/ml和(13.37±3.19)pg/ml,明显高于对照组(P<0.05),而UⅡ、左心室射血分数(LVEF)和左室缩短分数(LVFS)分别为(8.93±1.67)ng/ml、(35.58±10.20)%和(23.39±7.26)%,明显低于对照组(P<0.05);重度心衰患儿血清CgA和CK-MB分别为(1104.92±113.20)ng/ml和(15.72±1.20a)pg/ml,明显高于无心衰、轻度心衰和中度心衰患儿(P<0.05),而UⅡ、LVEF和LVFS分别为(6.98±1.14)ng/ml、(29.82±5.10)%和(20.04±3.11)%,明显低于无心衰、轻度心衰和中度心衰患儿(P<0.05);CgA与LVEF、LVFS呈正相关(r=0.410、0.378,P<0.05);CK-MB与LVEF、LVFS呈正相关(r=0.367、0.382,P<0.05);UⅡ与LVEF、LVFS呈负相关(r=-0.402、-0.410,P<0.05)。结论心肌炎患儿CgA和CK-MB水平升高,而UⅡ水平降低,可用于反映患儿病情程度及左室功能不全。

Objective To investigate the expression and significance of serum chromogranin A(CgA), urotensin II(UⅡ) and creatine kinase isoenzyme MB(CK-MB) in children with myocarditis. Methods From January 2015 to January 2018, 98 children with viral myocarditis(observation group) were selected, including 23 children without heart failure, 33 children with mild heart failure, 25 children with moderate heart failure and 17 children with severe heart failure, 100 healthy children were selected as the control group, the serum CgA, UII, CK-MB levels were detected and echocardiography was performed. Results The serum CgA and CK-MB levels in the observation group were(963.29±104.33) ng/ml and(13.37±3.19) pg/ml,which were significantly higher than those in the control group(P<0.05), while UⅡ, left ventricular ejection fraction(LVEF) and left ventricular fraction of shortening(LVFS) were(8.93±1.67) ng/ml,(35.58±10.20)% and(23.39±7.26)%, which were significantly lower than those in the control group(P<0.05);The serum CgA and CK-MB levels in children with severe heart failure were(1104.92±113.20) ng/ml and(15.72±1.20 a) pg/ml, which were significantly higher than those in children without heart failure, mild heart failure and moderate heart failure(P<0.05), while UII, LVEF and LVFS were(6.98±1.14) ng/ml,(29.82±5.10)%and(20.04±3.11)%, which were significantly lower than those in children without heart failure,mild heart failureand moderate heart failure(P<0.05);CgA were positively correlated with LVEF and LVFS(r=0.410, 0.378, P<0.05);CK-MB were positively correlated with LVEF and LVFS(r=0.367, 0.382, P<0.05);UⅡ were negatively correlated with LVEF and LVFS(r=-0.402,-0.410, P<0.05). Conclusion CgA and CK-MB levels are elevated in children with myocarditis, while UII levels are decreased, which can be used to reflect the degree of disease and left ventricular dysfunction.