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 detection in the diagnosis of myocardial injury in children with sepsis

目的研究血清心脏型脂肪酸结合蛋白(FABP3)联合糖原磷酸化酶脑型(GPBB)检测在小儿脓毒症心肌损伤诊断中的临床价值。方法选用回顾性分析方法,研究对象为2018年1月至2020年6月延安大学附属医院收治入院的87例脓毒症患儿,根据是否出现心肌损伤分为心肌损伤组(38例)与非心肌损伤组(49例);同时,将同一时期入院的44例非脓毒症感染性疾病患儿设为对照组。比较3组患儿的血清FABP3、GPBB与心肌损伤指标[肌红蛋白(Myo)、心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)]水平,并分析血清FABP3、GPBB与心肌损伤指标的相关性,通过绘制受试者工作特征(ROC)曲线评估FABP3、GPBB对小儿脓毒症心肌损伤的诊断效能。结果与对照组比较,心肌损伤组、非心肌损伤组血清FABP3、GPBB、Myo、cTnI、CK-MB水平更高,差异均有统计学意义(P<0.05);与非心肌损伤组比较,心肌损伤组血清FABP3、GPBB、Myo、cTnI、CK-MB水平更高,差异均有统计学意义(P<0.05)。脓毒症患儿血清FABP3、GPBB水平与Myo、cTnI、CK-MB水平均呈正相关(P<0.05)。FABP3诊断小儿脓毒症心肌损伤的ROC曲线下面积(AUC)、最佳截断值、灵敏度、特异度及准确度依次为0.775、18.23 ng/mL、0.78、0.82、0.75;GPBB诊断小儿脓毒症心肌损伤的的AUC、最佳截断值、灵敏度、特异度及准确度依次为0.822、13.55 ng/mL、0.81、0.86、0.78;FABP3联合GPBB诊断小儿脓毒症心肌损伤的的AUC、灵敏度、特异度及准确度依次为0.875、0.86、0.91、0.86。结论小儿脓毒症心肌损伤诊断中,血清FABP3联合GPBB检测具有重要的临床价值,且可评估心肌损伤程度。

Objective To study the clinical value of serum cardiac fatty acid binding protein(FABP3)combined with glycogen phosphorylase brain type(GPBB)detection in the diagnosis of myocardial injury in children with sepsis.Methods Using retrospective analysis methods,87 children with sepsis admitted to the Affiliated Hospital of Yan'an University from January 2018 to June 2020 were selected as the research objects.They were divided into myocardial injury group(38 cases)and non-myocardial injury group(49 cases)according to whether there was myocardial injury.At the same time,44 children with non-septic infectious diseases admitted to the hospital during the same period were set as the control group.The serum FABP3,GPBB and myocardial injury indicators[myoglobin(Myo),cardiac troponin I(cTnI),creatine kinase isoenzyme(CK-MB)]levels of the three groups were compared,and the correlation between serum FABP3,GPBB and myocardial injury indexes was analyzed.The diagnostic efficacy of FABP3 and GPBB on myocardial injury in children with sepsis is evaluated by drawing the receiver operating characteristic(ROC)curve.Resluts Compared with the control group,the levels of serum FABP3,GPBB,Myo,cTnI,and CK-MB in the myocardial injury group and the non-myocardial injury group were higher,and the differences were statistically significant(P<0.05);compared with the non-myocardial injury group,the levels of serum FABP3 GPBB,Myo,cTnI and CK-MB in the myocardial injury group were higher,and the differences were statistically significant(P<0.05).Serum FABP3 and GPBB levels in children with sepsis were positively correlated with Myo,cTnI,and CK-MB levels(P<0.05).The area under the ROC curve(AUC),best cut-off value,sensitivity,specificity and accuracy of FABP3 in the diagnosis of myocardial injury in children with sepsis were 0.775,18.23 ng/mL,0.78,0.82,and 0.75;GPBB in the diagnosis of children with sepsis the AUC,best cut-off value,sensitivity,specificity and accuracy of myocardial injury were 0.822,13.55 ng/mL,0.81,0.86,0.78;FABP3 combined with GPBB for the diagnosis of myocardial injury in children with sepsis,AUC,sensitivity,and specificity Degree and accuracy were 0.875,0.86,0.91,0.86.Conclusion In the diagnosis of myocardial injury in children with sepsis,the detection of serum FABP3 combined with GPBB has important clinical value and can assess the degree of myocardial injury.