心肌肌钙蛋白Ⅰ、肌酸激酶同工酶及高敏C反应蛋白检测与病毒性心肌炎诊断的临床研究

目的探讨心肌肌钙蛋白Ⅰ(cTnI)、肌酸激酶同工酶(CK-MB)和高敏C反应蛋白(hs-CRP)联合检测对病毒性心肌炎(VMC)的诊断价值。方法将114例患儿分为病毒性心肌炎组、疑似心肌炎组及非心肌炎组,所有患儿入院次日晨空腹采静脉血,分别测定cTnI、CK-MB和hs-CRP三个指标。结果病毒性心肌炎组的cTnI和CK-MB阳性率及hs-CRP的测定值均显著高于非心肌炎组(P<0.01);病毒性心肌炎组cTnI和CK-MB阳性率与疑似心肌炎组比较差异无统计学意义(P>0.05);病毒性心肌炎组与疑似心肌炎组及非心肌炎组hs-CRP测定值比较差异有统计学意义(P<0.01)。单个指标cTnI、CK-MB和hs-CRP诊断VMC的灵敏度依次为cTnI(81.4%)>CK-MB(71.2%)>hs-CRP(62.7%),特异度为hs-CRP(81.8%)>cTnI(50.9%)>CK-MB(43.6%)。三项指标联合检测对VMC诊断的特异度(85.5%)分别高于应用cTnI、CK-MB和hs-CRP单一指标。结论联合应用cTnI、CK-MB和hs-CRP进行检测,能更准确诊断VMC,为建立一种联合检测以提高对VMC的诊断提供理论依据。

Determination of serum cTnl,CK-MB and hs-CRP and their implication in the clinical diagnosis of viral myocarditis

Objectives To evaluate the diagnostic value of co-detecting serum levels of cTnI,CK-MB and hs-CRP in viral myocarditis(VMC). Methods One hundred and fureteen children were divided into VMC group,suspected-VMC group and non-VMC group. Serum levels of cTnI,CK-MB and hs-CRP were detected in all the children. Results The serum levels of cTnI,CK-MB and hs-CRP in VMC group were much higher than those in non-VMC group(P < 0.01=. There were no significant difference between serum levels of cTnI and CK-MB in VMC group and suspected-VMC group(P > 0.05). The serum level of hs-CRP in VMC group was much higher than that in suspected-VMC group and non-VMC group(P < 0.01=. The sensitivity rate was cTnI(81.4%)> CK-MB(71.2%)> hs-CRP(62.7%)and the specificity rate was hs-CRP(81.8%)> cTnI(50.9%)> CK-MB(43.6%). The specificity of co-detection of 3 indices(85.5%)was much higher than that of each single index. Conclusions Co-detection of serum levels of cTnI,CK-MB and hs-CRP is more specific than that of single index and it may enhance the accuracy of diagnosis for VMC.