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目的研究病毒性心肌炎(VMC)时血清心肌肌钙蛋白I(cTnI)升高在其诊断及预后中的价值。方法采用化学发光酶免分析定量检测法、免疫抑制法、ELISA法分别进行cTnI,CK-MB病毒抗体检测。结果140例临床诊断VMC患者血清cTnI值为(0.23±0.37)ng/ml,与对照组(0.0 ng/ml)比较显著增高P<0.01。其中89例患者血清cTnI值升高,阳性率63.57%,明显高于CK-MB阳性率27.14%,P<0.01。动态观察组68例cTnI升高者,1个月转阴率76.47%,2个月转阴率94.12%,半年时间内全部转阴。12例重症患者血清cTnI全部升高,其值为(0.53±0.36)ng/ml,并且转阴时间长,大多超过1个月。140例VMC患者中,柯萨奇病毒抗体IgM 阳性者中cTnI阳性率72.55%,显著高于柯萨奇病毒抗体IgM阳性者中阳性率49.06%,二者比较有显著性差异,P<0.01。结论VMC患者血清升高是诊断VMC患者心肌损伤的客观依据,具有高度的特异性和敏感性,诊断时间窗长,对VMC的诊断及预后具有重要意义。
Objective To investigate the value of serum cardiac troponin I (cTnI) in the diagnosis and prognosis of viral myocarditis (VMC). Methods Quantitative detection of chemiluminescence enzyme immunoassay, immunosuppression and ELISA were used to detect cTnI, CK-MB virus antibodies respectively. Results The serum cTnI of 140 clinically diagnosed VMC patients was (0.23 ± 0.37) ng / ml, which was significantly higher than that of the control group (0.0 ng / ml) (P <0.01). Serum cTnI increased in 89 patients, the positive rate was 63.57%, significantly higher than CK-MB positive rate of 27.14%, P <0.01. In the dynamic observation group, 68 cases with elevated cTnI had a negative conversion rate of 76.47% at 1 month and 94.12% at 2 months, all of which were negative within half a year. Serum cTnI in all 12 critically ill patients was elevated, with a value of (0.53 ± 0.36) ng / ml and a long negative conversion time, mostly for more than 1 month. Among 140 cases of VMC, the positive rate of cTnI in Coxsackie-B virus positive patients was 72.55%, which was significantly higher than that of Coxsackie’s IgM-positive patients (49.06%). There was a significant difference between the two (P <0.01). Conclusion Serum elevation in patients with VMC is an objective basis for the diagnosis of myocardial injury in patients with VMC. It is highly specific and sensitive and has a long diagnostic time-window, which is of great significance for the diagnosis and prognosis of VMC.