心肌肌钙蛋白I、肌酸激酶同工酶质量及高敏C反应蛋白在小儿病毒性心肌炎中的诊断价值

目的评价联合检测心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶质量(CK-MB mass)和高敏C反应蛋白(hs-CRP)在病毒性心肌炎(VMC)中的诊断价值。方法病毒性心肌炎组67例、疑似心肌炎组(NVMC组)72例及健康对照组小儿L 65例。所有患儿入院次日早晨空腹采静脉血,分别测定血清cTnI、CK-MB mass和hs-CRP水平。结果 VMC组的cTnI、CK-MB mass及hs-CRP的测定值均显著高于非心肌炎组(P<0.01)。单个指标cTnI、CK-MBmass和hs-CRP诊断VMC的灵敏度依次为hs-CRP(68.66%)>cTnI(65.67%)>CK-MB mass(55.22%),特异度为cTnI(100.00%)>CK-MB mass(93.06%)>hs-CRP(81.94%)。3项指标联合检测对VMC诊断的准确率(92.09%),均高于应用cTrI、CK-MB mass和hs-CRP单一指标。3项指标对VMC患儿的动态检测结果及阳性率表明,VMC患者康复时以hs-CRP恢复最快,CK-MB mass次之,cTnI最慢。结论联合应用cTnI、CK-MB mass和hs-CRP检测,能更准确地诊断VMC,为建立一种联合检测方法以提高对VMC的诊断提供理论依据。

Diagnostic value of serum cTnl,CK-MB mass and hs-CRP in children patients with viral myocarditis

Objective To evaluate the diagnostic value of co-detecting serum levels of cTnI,CK-MB mass and hsCRP in children with viral myocarditis（VMC）.Methods All 67 eases of VMC,72 cases of suspected myocarditis（NVMC） and 65 cases of healthy control children were included.Serum levels of cTnI,CK-MB mass and hs-CRP were detected in all the children.Results The serum levels of cTnI,CK-MB mass and hs-CRP in VMC group were much higher than those in NVMC groups（P 0.01）.The sensitivity of single index of cTnl,CK-MB mass and hs-CRP in diagnosis of VMC was hsCRP （68.66%） cTnI（65.67%） CK-MB mass（55.22%）,and the specificity was cTnI（100.00%） CK-MB mass （93.06%） hs-CRP（81.94%）.The diagnosis specificity of combined determination of the three parameters for VMC （92.09%） was higher than the single index of cTnI,CK-MB mass and hs-CRP.The dynamic detection of the three indicators in children with VMC indicated that during the rehabilitation of the patients,hs-CRP recovered fastest,CK-MB recovered the second fastest,cTnI recovered most slowly.Conclusion Co-detection of serum levels of cTnI,CK-MB mass and hs-CRP is more specific than the single index and it may enhance the accuracy of diagnosis for VMC.