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目的探讨心肌肌凝蛋白轻链-1(CMLC-1)在小儿病毒性心肌炎(VMC)诊治中的应用价值。方法对63例VMC患儿(VMC组)和42例健康儿(对照组)检测血清CMLC-1和心肌肌钙蛋白T(cTnT),进行相关性分析;并对不同心功能级别VMC患儿CMLC-1比较,VMC患儿心血管事件发生组与未发生组CMLC-1、左室射血分数(LVEF)比较。结果 VMC组患儿血清CMLC-1、cTnT水平较对照组明显升高(均P<0.01),治疗后较治疗前明显下降(P<0.01)。CMLC-1与cTnT水平呈显著正相关(P<0.01)。心功能分级不同,CMLC-1水平不同,心功能愈差,CMLC-1水平愈高,差异有统计学意义(P<0.01),发生心血管事件的VMC患儿血清CMLC-1水平明显高于未发生者(P<0.01),CMLC-1水平与LVEF呈显著负相关(P<0.01)。结论血清CMLC-1水平可作为VMC诊断、病情严重程度评估及预后判定的指标。
Objective To investigate the value of cardiac myosin light chain-1 (CMLC-1) in diagnosis and treatment of viral myocarditis (VMC) in children. Methods The serum levels of CMLC-1 and cardiac troponin T (cTnT) in 63 children with VMC (VMC group) and 42 healthy children (control group) were analyzed. Correlation analysis was made between the levels of CMLC -1 in children with VMC compared with those in the non-occurrence group, the incidence of cardiovascular events in patients with CMLC-1, left ventricular ejection fraction (LVEF). Results Serum levels of CMLC-1 and cTnT in VMC group were significantly higher than those in control group (all P <0.01), and were significantly decreased after treatment (P <0.01). There was a significant positive correlation between CMLC-1 and cTnT (P <0.01). The level of CMLC-1 was higher in CMLC-1 group than that in CMLC-1 group (P <0.01). The serum level of CMLC-1 in VMC with cardiovascular event was significantly higher than that in CMMC-1 group (P <0.01). The level of CMLC-1 was negatively correlated with LVEF (P <0.01). Conclusion Serum level of CMLC-1 can be used as an indicator of VMC diagnosis, severity of disease and prognosis.