血清心脏型脂肪酸结合蛋白联合糖原磷酸化酶脑型检测在小儿脓毒症心肌损伤诊断中的临床价值

The value of serum cardiac fatty acid binding protein combined with glycogen phosphorylase brain type in the diagnosis of myocardial injury in children with sepsis

目的研究小儿脓毒症心肌损伤诊断中血清心脏型脂肪酸结合蛋白(FABP3)联合糖原磷酸化酶脑型(GPBB)检测的应用价值。方法采用回顾性分析方法,研究对象为2019年1月至2020年1月葫芦岛市中心医院收治的87例脓毒症患儿,根据是否出现心肌损伤划分为2组,心肌损伤患儿列入A组,共38例,未出现心肌损伤患儿列入B组,共49例;同时,选取同一时期入院就诊的44例的非脓毒症感染性疾病患儿作为研究对象,列入C组。3组患儿均选取用全自动血气分析仪测定肌红蛋白、肌钙蛋白Ⅰ,并选取酶联免疫吸附实验法测定GPBB、FABP3及肌酸激酶同工酶,比较3组患儿肌红蛋白、肌钙蛋白Ⅰ、GPBB、FABP3及肌酸激酶同工酶水平,并分析心肌损伤指标肌红蛋白、肌钙蛋白Ⅰ、肌酸激酶同工酶与血清FABP3、GPBB相关性。结果A组[(396.85±13.07)ng/mL、(3.08±0.06)ng/mL、(22.78±1.02)ng/mL、(34.45±2.41)ng/mL、(44.08±6.53)U/L]、B组[(68.26±12.45)ng/mL、(0.12±0.04)ng/mL、(9.17±1.08)ng/mL、(13.64±2.52)ng/mL、(20.85±7.01)U/L]患儿肌红蛋白、肌钙蛋白Ⅰ、GPBB、FABP3及肌酸激酶同工酶水平明显高于C组[(17.16±10.09)ng/mL、(0.04±0.03)ng/mL、(2.58±1.02)ng/mL、(4.34±3.02)ng/mL、(9.17±6.73)U/L],差异有统计学意义(P<0.05);A组患儿肌红蛋白、肌钙蛋白Ⅰ、GPBB、FABP3及肌酸激酶同工酶水平明显高于B组,差异有统计学意义(P<0.05)。脓毒症患儿血清FABP3、GPBB与肌红蛋白、肌钙蛋白Ⅰ、肌酸激酶同工酶均呈正相关(r=0.602、0.521;r=0.466、0.494;r=0.528、0.489,P<0.05)。结论小儿脓毒症心肌损伤诊断中血清FABP3联合GPBB检测的应用效果显著,可用于评估脓毒症患儿心肌损伤严重程度。

Objective To study the application of serum Fatty acid-binding Protein 3(FABP3)combined with glycogen phosphorylase(GPBB)in the diagnosis of pediatric sepsis cardiac injury.Methods Retrospective analysis was used to study 87 cases of children with sepsis who were admitted to Huludao Central Hospital from January 2019 to January 2020.According to whether there was myocardial injury,they were divided into two groups:38 cases were included in group A,and 49 cases were included in group B.At the same time,44 children with non-sepsis infectious diseases admitted to hospital during the same period were selected as research objects and included in group C.Three groups of children are selected by automatic blood gas analyzer determination of myoglobin,troponin I,and the selection method of enzyme-linked immunosorbent determination of GPBB,FABP3 and creatine kinase isoenzyme,compare three groups of children with myoglobin,troponin I,GPBB,FABP3 and creatine kinase isozyme level,and analyze the myocardial injury index myoglobin,troponin I,and serum creatine kinase isozyme FABP3,GPBB correlation.Results The levels of myoglobin,troponin I,GPBB,FABP3 and creatine kinase isoenzymes in group A[(396.85±13.07)ng/mL,(3.08±0.06)ng/mL,(22.78±1.02)ng/mL,(34.45±2.41)ng/mL,(44.08±6.53)U/L]and B[(68.26±12.45)ng/mL,(0.12±0.04)ng/mL,(9.17±1.08)ng/mL,(13.64±2.52)ng/mL,(20.85±7.01)U/L]were significantly higher than group C[(17.16±10.09)ng/mL,(0.04±0.03)ng/mL,(2.58±1.02)ng/mL,(4.34±3.02)ng/mL,(9.17±6.73)U/L],the differences were statistically significant(P<0.05).The levels of myoglobin,troponin I,GPBB,FABP3 and creatine kinase isoenzymes in group A were significantly higher than those in group B,the differences were statistically significant(P<0.05).Serum FABP3 and GPBB are positively correlated with myoglobin,troponin I and creatine kinase isoenzyme in children with sepsis(r=0.602,0.521;r=0.466,0.494;r=0.528,0.489,P<0.05).Conclusion In the diagnosis of myocardial injury in children with sepsis,the application of serum FABP3 combined with GPBB detection has a significant effect,which can be used to evaluate the severity of myocardial injury in children with sepsis.