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目的:探讨心肌肌钙蛋白I(cTnI)与肌酸激酶同功酶-MB(CK-MB)在小儿心肌炎诊断中的应用。方法:选择2008年6月～2010年12月急性心肌炎患儿92例,同时选择86例健康儿童作为对照组,入院时和住院2周检测患儿cTnI和CK-MB水平,比较患儿入院时、治疗2周时cTnI和CK-MB水平。结果:心肌炎患儿cTnI和CK-MB水平较正常儿童显著升高(P<0.05);cTnI检测异常率(76.1%)显著高于CK-MB检测异常率(50.0%)(P<0.05);治疗2周后,CK-MB恢复正常,而cTnI水平仍显著高于对照组(P<0.05);心电图异常者,cTnI检测异常率(90.5%)显著高于CK-MB检测异常率(76.2%)(P<0.05)。结论:cTnI、CK-MB对小儿心肌炎的诊断均较敏感,其中cTnI对心肌损害的敏感性及特异性高于CK-MB;cTnI诊断时间窗宽于CK-MB,特异性也高于心肌酶学检查。
Objective: To investigate the application of cardiac troponin I (cTnI) and creatine kinase isoenzyme MB (CK-MB) in the diagnosis of pediatric myocarditis. Methods: 92 children with acute myocarditis were selected from June 2008 to December 2010,86 healthy children were selected as control group. The levels of cTnI and CK-MB in children were detected at admission and 2 weeks after hospitalization. , CTnI and CK-MB levels at 2 weeks of treatment. Results: The levels of cTnI and CK-MB in children with myocarditis were significantly higher than those in normal children (P <0.05). The abnormal rate of cTnI test (76.1%) was significantly higher than that of CK-MB test (50.0%) (P <0.05). After 2 weeks of treatment, the CK-MB returned to normal while the cTnI level was still significantly higher than that of the control group (P <0.05). The abnormal rate of cTnI test (90.5%) was significantly higher than that of CK-MB test (76.2% ) (P <0.05). Conclusion: cTnI and CK-MB are sensitive to the diagnosis of myocarditis in children. The sensitivity and specificity of cTnI in myocardial damage are higher than that of CK-MB. The time window of cTnI diagnosis is longer than that of CK-MB and the specificity is higher than that of myocardial enzymes School inspection.