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目的评估血清心肌肌钙蛋白I(cTnI)对小儿心肌炎的诊断价值,并与肌酸激酶(CK)及其同功酶MB(CK-MB)进行对比研究.方法全自动生化分析仪对cTnI,CK及CK-MB进行定量检测.结果1)心肌炎组cTnI,CK及CK-MB均明显高于正常对照组(P<0.001).cTnI升高38例,占76%;CK升高21例,占42%;CK-MB升高25例,占50%.cTnI与CK,CK-MB呈正相关关系.2)治疗2周后,cTnI与对照组比较有显著性差异(P<0.001),CK及CK-MB与对照组无显著性差异(P>0.05).3)心肌炎组22例ST-T改变患儿测cTnI升高20例(91%),CK升高8例(37%),CK-MB升高6例(27%).结论cTnI及CK,CK-MB对小儿心肌炎的诊断均较敏感,其中cTnT对心肌损害的敏感性及特异性均高于CK和CK-MB.cTnI诊断时间窗宽于CK,CK-MB,特异性也高于心肌酶学检查.
Objective To evaluate the diagnostic value of serum cardiac troponin I (cTnI) in children with myocarditis and to compare it with creatine kinase (CK) and its isoenzyme MB (CK-MB) .Methods Automatic biochemical analyzer was used to evaluate cTnI, CK and CK-MB were detected by immunohistochemical method.Results 1) The levels of cTnI, CK and CK-MB in myocarditis group were significantly higher than those in normal control group (P <0.001), cTnI increased in 38 cases (76%), CK increased in 21 cases Accounting for 42%; CK-MB increased in 25 cases, accounting for 50% .There was a positive correlation between cTnI and CK and CK-MB.2) After 2 weeks of treatment, cTnI was significantly different from the control group (P <0.001) (P> 0.05) .3) In 22 children with myocarditis, the cTnI level was increased in 20 (91%) and CK (8%) in 37 children with ST-T changes CK-MB increased in 6 cases (27%) .Conclusion cTnI, CK and CK-MB are sensitive to the diagnosis of myocarditis in children, and the sensitivity and specificity of cTnT to CK are higher than that of CK and CK-MB.cTnI Diagnostic time window wider than CK, CK-MB, specificity is higher than myocardial enzymology.