【摘要】 目的:探讨联合检测心肌损伤标志物对病毒性心肌炎(VMC)患儿心肌损伤的诊断价值。方法:对52例VMC、58例非病毒性心肌炎(NVMC)患儿和50例健康对照者,分别检测血清3种心肌损伤标志物[心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶MB质量(CK-MBmass)、肌红蛋白(MYO)]浓度和4种心肌酶活性。结果:入院当日VMC组cTnI(0.41±0.19)μg/L、CK-MBmass(6.02±3.89)μg/L、MYO(102.33±41.42)μg/L,均明显比NVMC组和对照组高(P<0.01);联合检测cTnI、CK-MBmass和MYO对VMC心肌损伤的诊断灵敏度(SE)、特异性(SP)、阳性预报值(PPV)、阴性预报值(NPV)和准确度(AC)分别为71.15%、96.30%、90.24%、87.39%和88.13%;SE和NPV与联合检测4种心肌酶相近(P>0.05),而SP、PPV和AC却明显比联合检测4种心肌酶高(P<0.01)。结论:联合并动态检测3种心肌损伤标志物比联合检测4种心肌酶能够为VMC心肌损伤的诊断、治疗和预后转归判断提供更好的诊断方法。更多还原

【Abstract】 Objective:To study the diagnostic value of myocardial damage in children with viral myocarditis by combined detection of cardiac markers. Methods:The concentrations of 3 kinds of cardiac markers of cardiac troponin I (cTnI),creatine kinase isoenzyme MB mass (CK-MB mass),myoglobin (MYO) and 4 kinds of myocardial enzymes in 52 patients with viral myocarditis (VMC) and 58 patients with non-viral myocarditis (NVMC) and 50 healthy children were detected,respectively. Results:The study revealed that VMC patients had obviously higher levels of cTnI,CK-MB mass and MYO compared with those in NVMC group and controls (P<0.01). The concentrations of cTnI,CK-MB mass and MYO in VMC group were (0.41±0.19) μg/L,(6.02±3.89) μg/L and (102.33±41.42) μg/L,respectively. The diagnostic efficiency of combined determination of cTnI,CK-MB mass and MYO for myocardial damage in VMC patients were 71.15% in sensitivity (SE),96.30% in specificity (SP),90.24% in positive predictive value (PPV),87.39% in negative predictive value (NPV) and 88.13% in accuracy (AC),respectively. Not only in SE but also in NPV,there were no significant difference between combined detection of 3 kinds of cardiac markers and combined measurement of 4 kinds of myocardial enzymes (P>0.05). However,the SP,PPV and AC of combined detection of 3 kinds of cardiac markers were higher compared with 4 kinds of myocardial enzymes (P<0.01). Conclusions:Combined and continued detection of 3 kinds of cardiac markers can provide better information for diagnosis,treatment and recovery than combined test on 4 myocardial enzymes for myocardial damage in VMC patients.更多还原