儿科危重疾病心肌肌钙蛋白I的变化

目的通过早期检测危重患儿心肌肌钙蛋白I（cTnI）的值，证实在儿童危重疾患时存在心肌损害。方法采用化学发光法和酶法测定49例儿科危重病患儿及25例轻症对照组的心肌cTnI、肌酸激酶（CK）及其同功酶（CK-MB）的值并计算其阳性率，同时观察两组患儿心电图的改变。结果危重儿组的cTnI、CK-MB阳性率高于对照组（48．9％vs0％，57．1％vs48．0％），CK的阳性率低于对照组（24．5％vs28．0％）。危重病儿组cTnI阳性率与对照组相比差异有非常显著统计学意义（P〈0．01），两组间CK-MB、CK阳性率差异无显著统计学意义（P〉0．05）。危重儿组心电图异常者cTnI阳性率为95．5％，而CK-MB和CK的阳性率分别为45．5％和27．3％，前者与后二者的阳性率相比，P〈0．001。结论危重儿除其原发性疾病的症状外，还存在心肌的损害。

The change of cardiac troponin I in pediatric critical diseases

Objective Cardiac troponin I is a highly specific marker of myocardial injury. Unlike other markers, its base line level can not be measured. Once heart demage occurred, it released and entered blood plasm. In this test, the values of cardiac troponin I in early pediatric critical diseases were detected, we confirmed there exist myocardial injury. Methods By using chemoluminescence technique and enzymic method, cardiac troponin I, creatine kinase isoenzyme MB （CK-MB） and creatine kinase （CK） were determined in 49 patients with critical disease and 25 mild case of control group in pediatrics. At the same time, we observed the changes of electrocardiographic in two groups. Results The positive rate of cTnI and CK-MB in patients with critical disease was higher than in mild cases of control group （49.0% vs 0%, 57.1% vs 48.0%）, but the former had significant difference （P〈0.001）. There was no significant difference in the positive rate of CK-MB and CK between the experimental group and the control group （P〉0.05）. The patients who electrocardiographic abnormality of the experiment group, their positive rate of cTnI was 95.5%, but that of CK-MB and CK is 45.5% and 27.3%, respectively. Compared to the positive rate of the former and the latter two, P〈0.001. Conclusions Except for the symptoms of primary diseases, there exist heart damage in patients with critical diseases.