【摘要】 目的观察心肌损伤患儿血浆E-选择素(ES)的水平及在心肌损伤中的诊断价值。方法检测65例心肌损伤患儿(心肌损伤组)和65例健康儿童(对照组)的ES水平的表达,采用肌钙蛋白Ⅰ(cTnⅠ)及肌酸激酶同工酶(CK-MB)作为对比,绘制ROC曲线,分析及评价ES在心肌损伤中的诊断价值,探讨性拟定0~14岁小儿心肌损伤评分法。结果心肌损伤组和对照组的ES水平分别为42.25±4.82 ng/ml,12.46±3.29 ng/ml;cTnⅠ分别为0.18±0.02μg/L,0.02±0.01μg/L;CK-MB分别为27.66±4.22 IU/L,9.46±4.77 IU/L;心肌损伤组ES、cTnI及CK-MB测定水平均明显高于和对照组,差异均有统计学意义(P均<0.001)。ROC曲线分析显示ES诊断心肌损害的曲线下面积(AUC)为0.945,95%CI为0.899~0.991,敏感度、特异度和约登指数分别为0.801、1.000和0.801,诊断界值29.67 ng/ml,阳性似然比为72.5。结论 E-选择素对心肌损伤具有较大的诊断价值,可能是心肌损伤的重要生物学标志物,可作为小儿心肌损伤评分的重要指标。更多还原

【Abstract】 Objective The aim of this study was to explore the significance of plasma level of E- selectin in diagnosis of myocardial impairment in children under 14 years of age. Methods The level of E- selectin was detected in 65 pediatric patients with myocardial impairment and 65 healthy children,and troponin Ⅰ( cTn Ⅰ) and creatine kinase isoenzyme MB( CK- MB) were applied for comparison. The value of E-selectin for diagnosis of myocardial impairment was analyzed by the receiver operating characteristic( ROC) curve. Results The levels of E- selectin,cTnI and CK- MB in 65 patients with myocardial impairment and 65 healthy children were 42. 25 ± 4. 82 ng / ml,0. 18 ± 0. 02 μg /L,27.66 ± 4. 22 IU / L and 12. 46 ± 3. 29 ng / ml,0. 02 ± 0. 01 μg / L,9. 46 ± 4. 77 IU / L respectively,and the difference between these two groups was statistically significant( P < 0. 001). ROC curve analysis showed that the area under E- selectin was 0. 945,the 95% CI were 0. 899- 0. 991;and the sensitivity,specificity and Youden index were 0. 801,0. 999 and 0. 801,respectively; and the cutoff value was 29. 67. The positive LR was 72. 5 in the diagnosis of myocardial impairment. Conclusion E- selectin has important significance in diagnosis of myocardial impairment,and it may be a very important biological marker for myocardial impairment,hence it can be used as an important scoring index for pediatric myocardial impairment.更多还原