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目的:分析感染性疾病患儿血清肌钙蛋白(cTnI)和心肌酶谱的水平,探讨cTnI和心肌酶谱对小儿心肌炎的诊断价值。方法:采用全自动化学发光免疫分析仪和全自动生化分析仪对806例感染性疾病患儿的血清cTnI、心肌酶谱肌酸激酶(CK)、同工酶CK-MB、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBDH)进行检测。结果:806例中cTnI升高者180例,占22.33%;CK升高者170例,占21.09%;CK-MB升高者338例,占41.94%;LDH升高者630例,占78.16%;α-HBDH升高者727例,占90.20%。806例患儿确诊心肌炎24例,发病率为2.98%;24例心肌炎中18例cTnI升高,占心肌炎总数的75.00%,占cTnI升高总数的10.00%;12例CK-MB升高,占心肌炎总数的50.00%,占CK-MB升高总数的3.55%。cTnI与CK-MB对小儿心肌炎诊断的差异有统计学意义(P<0.01)。结论:小儿感染性疾病易伴有心肌酶谱和cTnI升高;cTnI检测比CK-MB检测对诊断心肌炎更有意义。
Objective: To analyze the levels of serum cardiac troponin (cTnI) and myocardial enzymes in children with infectious diseases and to explore the diagnostic value of cTnI and myocardial enzymes in children with myocarditis. Methods: Serum levels of cTnI, CK, CK-MB and lactate dehydrogenase (CK-MB) in 806 children with infectious diseases were measured by automatic chemiluminescence immunoassay analyzer and automatic biochemical analyzer. LDH), α-hydroxybutyrate dehydrogenase (α-HBDH) were detected. Results: Among 806 cases, cTnI increased in 180 cases (22.33%), CK increased in 170 cases (21.09%), CK-MB increased in 338 cases (41.94%), LDH increased in 630 cases (78.16% ; 727 cases of elevated α-HBDH, accounting for 90.20%. Twenty-four patients with myocarditis were found to have cTnI, accounting for 75.00% of total myocarditis, accounting for 10.00% of the total number of patients with myocarditis; 12 patients had elevated CK-MB, accounting for Myocarditis 50.00% of the total, accounting for 3.55% of the total increase in CK-MB. The differences of cTnI and CK-MB in the diagnosis of children’s myocarditis were statistically significant (P <0.01). Conclusion: Infectious diseases in children are easily accompanied by increased myocardial enzymes and cTnI; cTnI test is more meaningful than CK-MB in the diagnosis of myocarditis.