高敏心肌肌钙蛋白T、心肌酶与心电图在儿童手足口病感染中的应用

目的探讨儿童手足口病(HFMD)患儿高敏心肌肌钙蛋白T(hs-cTnT)、心肌酶和心电图变化与心肌受损之间关系。方法对241例HFMD患儿及203名健康儿童进行hs-cTnT、天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、乳酸脱氢酶同工酶(LD1)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)测定和心电图检测。分析2组之间的hs-cTnT、心肌酶水平及异常率和心电图异常率的差异。结果 HFMD组hs-cTnT、心肌酶水平及异常率明显高于对照组(P<0.01),心电图异常率(包括ST-T段改变、传导阻滞、早博、异位心动过速)也高于对照组(P<0.01)。HFMD患儿hs-cTnT异常率要高于其他心肌酶指标。结论血清hs-cTnT、心肌酶及心电图检测可作为早期判断HFMD患儿心肌受损及心功能评价的辅助诊断指标,且血清hs-cTnT有较好的临床应用前景。

The clinical application of hs-cTnT,cardiac enzyme and electrocardiogram in HFMD of children

Objective To investigate the relationship of high-sensitivity cardiac troponin T（hs-cTnT）,cardiac enzyme and electrocardiogram with myocardial injury in hand-foot-mouth disease（HFMD） of children.Methods The levels of hs-cTnT,aspartate aminotransferase（AST）,lactate dehydrogenase（LDH）,lactate dehydrogenase isoenzyme 1（LD1）,creatine kinase（CK） and creatine kinase MB isoenzyme（CK-MB） were determined in 241 children with HFMD and 203 healthy children.Their electrocardiogram was examined.The levels of hs-cTnT,the levels of cardiac enzymes,the abnormal rates and electrocardiogram abnormal rates were analyzed between the 2 groups.Results The levels of hs-cTnT and cardiac enzyme,the abnormal rates and the abnormal rates of ST-T,conduction blockade,bearing premature and pyknocardia in HFMD group were significantly higher than those of control group（P0.01）.The abnormal rate of hs-cTnT was significantly higher than those of cardiac enzymes.Conclusions The levels of hs-cTnT and cardiac enzymes and electrocardiogram may be indicators for the diagnosis of myocardial injury and heart function in children with HFMD.The level of hs-cTnT has better diagnostic value.