血清心肌肌钙蛋白Ⅰ判断病毒性心肌炎炎性损伤及预后的探讨

目的探讨心肌肌钙蛋白I(cTnI)判断急性病毒性心肌炎炎性损伤程度及预后。方法采用抗人cTnI单抗，应用酶联免疫法测定52例急性病毒性心肌炎患者血清cTnI，同时作肌酸磷酸激酶及其同工酶(CK，CK-MB)检测，血清cTnI>7μg／L为阳性。第1次cTnI阳性者第2次复查仍然阳性者归入cTnI持续阳性组(18例)，复查cTnI阴性者归入cTnI阴性组(20例)。结果cTnI阴性组与cTnI持续阳性组临床症状好转率、心律失常治愈率比较均有极显著性差异(P<0．01)。cTnI持续阳性组中，有2例患者发展为心肌炎后心肌病。52例急性病毒性心肌炎患者中第1次检测cTnI有38例患者cTnI阳性(73．1％)，有3例CK-MB异常(5．8％)。cTnI持续阳性组柯萨奇B病毒中和抗体转阴率明显低于cTnI阴性组，两者比较P<0．05。结论cTnI可作为急性病毒性心肌炎炎性损伤及预后判断的指标。

The prognostic value of serum cardiac troponin-I in virus myocarditis

Objective:To investigate the prognostic value of serum cardiac troponin-I (cTnI) in virus myocarditis.Method:The concentration of serum cTnI and CK,CK-MB were simultaneously measured with monoclonal antibody to cTnI by ELISA method.38 from 52 cases were cTnI positive at first time.The 38 patients with acute virus myocarditis were divided into cTnI positive (n＝18) and negative groups (n＝20) while measured repeatedly in 3 months.Result:The recovery rate of arrhythmia and symptom improved rate were 33.3% vs 70.0% and 22.2% vs 70.0% respectively between the cTnI positive and negative groups and thereby showed significant statistically.38 (73.1%) cases were cTnI positive while only 3(5.8%)showed CK-MB positive among the total 52 cases from their first time test and there was significant difference of the positive rates between two methods (P<0.01).Serum negative conversion rate of the neutralizing antibody to the coxsackie B was lower (33.3%)in the cTnI positive group compared with the 69.2% in the cTnI negative group. Conclusion: cTnI may indicate the severity of inflammatory injury from the virus myocarditis and predict the prognosis of the illness.