心肌肌钙蛋白T检测在小儿急性病毒性心肌炎诊断及预后观察中的应用

目的 探讨心肌肌钙蛋白T（cTnT）在儿童病毒性心肌炎（VMC）诊断、病情观察及预后判断方面的应用价值。方法 对126例急性VMC患儿入院24小时内，以及入院后1、2、3周及3个月cTnT和心肌酶谱进行动态观察；VMC患儿心电图（ECG）检查结果与cTnT 的对照分析；VMC患儿cTnT阳性组与cTnT阴性组治愈率比较。结果 急性VMC患儿cTnT阳性率显著高于同期心肌酶谱中各项目阳性率（P<0.005;P<0.05）; VMC患儿入院治疗后在连续的监测中cTnT含量逐渐减低，3周时cTnT含量已显著低于入院时(P<0.05)。cTnT阳性组ECG异常率（92.4%）显著高于cTnT阴性组ECG异常率（66.7%）P<0.005。3个月的总治愈率cTnT阴性组（95%，57/60）显著高于阳性组（66.7%，44/66）（P<0.005）。结论 在VMC的诊断中cTnT可取代传统的心肌酶谱检测，动态监测cTnT含量对VMC患儿的病情及疗效判断以及预后具有重要价值。

The Application of Cardic Troponin T in The Diagnosis and Prognosis Estimation in Children with Acute Viral Myocarditis

[Abstract] Objective To investigate the value of cardic troponin T (cTnT) in the diagnosis and prognosis estimation in children with acute viral myocarditis(VMC).Methods Serum cTnT and Cardiac enzymes were measured in 126 children with acute VMC at different stages(admission,24 hours,1 week,2 weeks,3 weeks ,3 months);Comparition study were performed between the result of cTnT With electrocardiograph(ECG); Comparition study were performed between the cure rate of cTnT positive group with negative group.Results The positive rate of cTnT was significantly higher than cardiac enzyme levels at different stages(P<0.005,P<0.05).The normal rate of ECG in positive group was significantly lower than negative group(P<0.05).The cure rate in positive group was significantly lower than in negative group at 3 months(P<0.005).Conclusions Measurement of serum levels of cTnT provides evidence of myocyte injury in patients with VMC more sensitively and speciiccally than does convention determination of cardiac enzyme levels;Cadic damage in positive group were more severe than in negative group.cTnT also play an important role in the observation in patients with VMC.