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目的 探讨心肌肌钙蛋白I(cTn -I)及抗心肌抗体 (AHA)与小儿心肌损伤的关系。方法 对 30例心肌炎 (MC)患儿及 1 8例正常儿童进行血清cTn -I、AHA、磷酸肌酸激酶同工酶 (CK -MB)测定。结果 ①MC组血清cTn -I、AHA、CK -MB的阳性率分别为70 .0 %、36 .7%、2 6 .7% ,均较对照组高 (P <0 .0 1 ) ,cTn -I与CK -MB阳性率比较差异有统计学意义 (P <0 .0 1 ) ;②MC发病病程≤ 1个月cTn -I阳性率较其他时期明显增高 (P <0 .0 5) ,而AHA阳性率较其他时期明显下降 (P <0 .0 1 ) ;③治疗 1 0dcTn -I下降≥ 50 %者及 2 0dcTn -I转阴者 ,临床症状和心律失常等改善明显优于cTn -I下降及转阴缓慢者 (P <0 .0 5)。结论 ①血清cTn -I的检测是判断心肌损伤的敏感指标 ,尤其适用于早期及微小心肌损伤的诊断 ;②血清AHA的检测是心肌损伤的后期诊断及预后判断指标。
Objective To investigate the relationship between cardiac troponin I (cTn-I) and anti-myocardial antibody (AHA) in children with myocardial injury. Methods Serum levels of cTn-I, AHA and CK-MB were measured in 30 children with myocarditis (MC) and 18 normal children. Results ① The positive rates of cTn-I, AHA and CK-MB in serum of the MC group were 70.0%, 36.7% and 26.7% respectively, which were significantly higher than those of the control group (P <0.01) (P <0.01). ② The positive rate of cTn-I in the course of onset of disease ≤ 1 month was significantly higher than that in other periods (P <0.05), while the AHA (P <0.01). ③ The improvement of clinical symptoms and arrhythmia was significantly better than that of cTn-I in treatment of those with 50d or 50dcTn-I declining And slow down more slowly (P <0.05). Conclusions ① The detection of serum cTn-I is a sensitive indicator of myocardial injury, especially for the diagnosis of early and minimal myocardial damage. ② The detection of serum AHA is the late diagnosis and prognostic indicator of myocardial injury.