病毒性心肌炎患儿心肌损伤标志物检测分析_药学论文.docVIP

病毒性心肌炎患儿心肌损伤标志物检测分析_药学论文 病毒性心肌炎患儿心肌损伤标志物检测分析_药学论文 【摘要】 目的：探讨联合检测心肌损伤标志物对病毒性心肌炎（VMC）患儿心肌损伤的诊断价值。方法：对52例VMC、58例非病毒性心肌炎（NVMC）患儿和50例健康对照者，分别检测血清3种心肌损伤标志物［心肌肌钙蛋白I（cTnI）、肌酸激酶同工酶MB质量（CK）、肌红蛋白（MYO）］浓度和4种心肌酶活性。结果：入院当日VMC组cTnI（0.41±0.19）μg/L、CK（6.02±3.89）μg/L、MYO（102.33±41.42）μg/L，均明显比NVMC组和对照组高（0.01）；联合检测cTnI、CK和MYO对VMC心肌损伤的诊断灵敏度（SE）、特异性（SP）、阳性预报值（PPV）、阴性预报值（NPV）和准确度（AC）分别为71.15%、96.30%、90.24%、87.39%和88.13%；SE和NPV与联合检测4种心肌酶相近（Pgt;0.05），而SP、PPV和AC却明显比联合检测4种心肌酶高（0.01）。结论：联合并动态检测3种心肌损伤标志物比联合检测4种心肌酶能够为VMC心肌损伤的诊断、治疗和预后转归判断提供更好的诊断方法。 【关键词】 病毒性心肌炎；心肌肌钙蛋白I；肌酸激酶同工酶MB质量；肌红蛋白；心肌酶 　　［Abstract］Objective:To study the diagnostic value of myocardial damage in children with viral myocarditis by combined detection of cardiac markers. Methods: The concentrations of 3 kinds of cardiac markers of cardiac troponin I (cTnI), creatine kinase isoenzyme MB mass (CKMB mass), myoglobin (MYO) and 4 kinds of myocardial enzymes in 52 patients with viral myocarditis (VMC) and 58 patients with nonviral myocarditis (NVMC) and 50 healthy children were detected, respectively. Results: The study revealed that VMC patients had obviously higher levels of cTnI, CKMB mass and MYO compared with those in NVMC group and controls (0.01). The concentrations of cTnI, CKMB mass and MYO in VMC group were (0.41±0.19) μg/L, (6.02±3.89) μg/L and (102.33±41.42) μg/L, respectively. The diagnostic efficiency of combined determination of cTnI, CKMB mass and MYO for myocardial damage in VMC patients were 71.15% in sensitivity (SE), 96.30% in specificity (SP), 90.24% in positive predictive value (PPV), 87.39% in negative predictive value (NPV) and 88.13% in accuracy (AC), respectively. Not only in SE but also in NPV, there were no significant difference between combined detection of 3 kinds of cardiac markers and combined measurement of 4 kinds of myocardial enzymes (Pgt;0.05). However, the SP, PPV and AC of combined detection of 3 kinds of cardiac markers were higher compared with 4 kinds of myocardial enzymes (0.01). Conc