心肌肌钙蛋白I和T联合检测在病毒性心肌炎诊断中的应用

目的探讨肌钙蛋I（cTnI）和肌钙蛋白T（cTnT）在病毒性心肌炎（VMC）的诊断及病情观察方面的价值。方法对79例VMC患者进行入院后1、2、3周及2个月cTnT和心肌酶谱的动态监测；cTnT、cTnI与心电图（ECG）及病程关系的研究。结果急性VMC患者在各检测期内血清cTnT的阳性率（73．41％）和cTnI的阳性率（67．08％）显著高于心肌酶谱各项目（P〈0．05）：肌酸激酶47．4d％、肌酸激酶同工酶51．28％、天冬氨酸氨基转移酶42．31％、乳酸脱氢酶42．31％、α-羟丁酸脱氢酶44．87％。cTnT和cTnI阳性组ECG正常率（5．26％、9．62％）明显低于阴性组（71．43％、57．69％）（P〈0．05）。结论在VMC的诊断中，cTnT和cTnI可取代传统的心肌酶谱测定作为判断急性心肌炎的指标；同时cTnT和cTnI在VMC病情进展的观察中也具有重要意义。

Applications of cardic troponin T and cardic troponin I in diagnosis of viral myocarditis

Objective To investigate the utility of cardiac troponin T （cTnT） and cardiac troponin I （cTnI） in diagnosis and pathogenetic condition observation of viral myocarditis （VMC）. Methods The serum levels of cTnT, cTnI and myocardial zymogram were monitored in 79 patients patients with viral myocarditis at 1 wk, 2 wk, 3 wk and 2 month timepoints after admission; in addition, the relationship of cTnT,cTnI and ECG change, course was investigated. Results In acute VMI patients,both the positive rate of cTnT（73.41% ） and cTnI （67.08%） were significantly higher than those of myocardial zymogram （CK 47.44%, CK-MB 51.28%, AST 42.31%, LDH 42.31%, α- HBDH 44.87%） （P〈0.05）. The ECG normalraces in cTnT and cTnI positive group were much lower than those in cTnT and cTnI negative group （5. 26% and 9. 62% vs 71.43% and 57.69%, P〈0.05）. Conclusion cTnT and cTnI can be used as useful alternatives to the mostly used biochemical items for diagnosing acute VMI. Moreover, the two items can also play an important role in minitoring the development of VMC.