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目的:探讨血清心肌肌钙蛋白I对小儿病毒性心肌炎(viralmyocarditis,VMC)心肌损害的早期诊断价值及对心功能的判断价值。方法:对VMC组21例,疑似VMC组24例及非心脏疾病患儿的对照组23例测定血清心肌肌钙蛋白I和肌酸激酶及其同工酶(creatinekinaseisoenzyme-MB,CK-MB),并将3组结果进行比较,同时对前二组中39例患儿测定左心功能指标(射血分数、缩短分数),比较心肌肌钙蛋白I与左心功能的关系。结果:VMC组心肌肌钙蛋白I、肌酸激酶、CK-MB值均明显高于疑似VMC组。对照组心肌肌钙蛋白I值均正常。VMC组及疑似VMC组心肌肌钙蛋白I阳性率均高于肌酸激酶、CK-MB阳性率。39例测定左心功能,VMC组射血分数异常率为57%(12/21),缩短分数异常率为48%(10/21),明显高于疑似VMC组犤6%(1/18)、11%(2/18)犦,两组比较差异统计学意义(P<0.01)。结论:血清心肌肌钙蛋白I早期诊断小儿VMC优于肌酸激酶、CK-MB,且可提示心肌受累的程度及判断心功能。
Objective: To investigate the value of serum cardiac troponin I in the early diagnosis of myocardial damage in children with viral myocarditis (VMC) and the value of cardiac function. Methods: Serum cardiac troponin I, creatine kinase and its isoenzyme (CK-MB) were detected in 21 cases of VMC group, 24 cases of suspected VMC group and 23 cases of non-heart disease control group. The results of three groups were compared. The left ventricular function (ejection fraction and fractional shortening) were measured in 39 children in the first two groups. The relationship between cardiac troponin I and left ventricular function was compared. Results: The levels of cardiac troponin I, creatine kinase and CK-MB in VMC group were significantly higher than those in the VMC group. Control group, cardiac troponin I values were normal. The positive rates of cardiac troponin I in VMC group and suspected VMC group were higher than that of creatine kinase and CK-MB. In 39 patients with left ventricular function, the abnormal rate of ejection fraction in VMC group was 57% (12/21), the shortening fractional abnormality rate was 48% (10/21), significantly higher than that in the suspected VMC group (6%, 1/18) , 11% (2/18) 犦, the difference between the two groups was statistically significant (P <0.01). Conclusion: Serum cardiac troponin I is better than creatine kinase and CK-MB in the early diagnosis of VMC in children, and can indicate the degree of myocardial involvement and determine the cardiac function.