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目的观察先天性心脏病(CHD)患儿血清心脏型脂肪酸结合蛋白(h-FABP)及肌酸磷酸激酶同功酶(CK-MB)水平变化,探讨检测血清h-FABP对CHD患儿心肌损害的早期诊断价值。方法对63例CHD患儿血清h-FABP和CK-MB值进行检测,并与30例正常对照组比较并进行统计学分析。结果CHD患儿组血清h-FABP及CK-MB水平分别显著高于对照组(P<0.01);CHD患儿组血清h-FABP阳性率(61.90%)显著高于CK-MB的阳性率(26.98%,P<0.01),提示:血清h-FABP比CK-MB具有更高的敏感性;心衰组、青紫组血清h-FABP及CK-MB水平分别显著高于非心衰组、非青紫组(P<0.01),说明:心衰组、青紫组心肌损伤的程度重于非心衰组、非青紫组。结论CHD患儿本身存在心肌细胞的损伤,合并心衰及缺氧时心肌细胞的损伤更为严重,血清h-FABP定量测定作为一种对微小心肌损伤高敏感的指标,可作为判断CHD患儿病情轻重的一项客观指标,且比CK-MB具有更高的敏感性。
Objective To observe the changes of serum levels of cardiac-type fatty acid binding protein (h-FABP) and creatine phosphokinase isoenzyme (CK-MB) in children with congenital heart disease (CHD) and to investigate the effect of serum h-FABP on myocardial damage The early diagnosis value. Methods The serum levels of h-FABP and CK-MB in 63 children with CHD were measured and compared with 30 normal controls and analyzed statistically. Results The serum levels of h-FABP and CK-MB in children with CHD were significantly higher than those in control group (P <0.01). The positive rate of serum h-FABP in CHD children was significantly higher than that of CK-MB (61.90% 26.98%, P <0.01), suggesting that the serum h-FABP is more sensitive than CK-MB; the levels of serum h-FABP and CK-MB in heart failure group and cyanosis group were significantly higher than those in non-heart failure group Cyanidrosis group (P <0.01), indicating that the degree of myocardial damage in heart failure group and cyanosis group is more than that in non-heart failure group and non-cyanosis group. Conclusion CHD children with myocardial cell damage itself, combined with heart failure and hypoxia when myocardial cell injury is more serious, serum h-FABP quantitative determination of myocardial micro-damage as a highly sensitive index can be used as a diagnosis of CHD children Sickness is an objective indicator of severity and is more sensitive than CK-MB.