心肌标志物联合检测对川崎病早期诊断的临床意义(1)
摘要：目的 探讨心肌标志物联合检测对川崎病患儿早期心肌损伤的诊断价值。方法 选取2016年1月～2018年12月本院收治的93例川崎病患儿，根据 cTnⅠ是否阳性分为心肌损伤组41例，无心肌损伤组52例，另选取同期来院体检的健康儿童45例设为健康对照组。采用白蛋白钴结合试验分别测定两组血清缺铁修饰白蛋白(IMA)、化学发光法检测肌钙蛋白Ⅰ(cTnⅠ)、免疫抑制法测定肌酸激酶同工酶(CK-MB)。结果 ①心肌损伤组的IMA、cTnⅠ、CK-MB 水平高于健康对照组和无心肌损伤组(P<0.05)，而无心肌损伤组的心电图、IMA、cTnⅠ、CK-MB和健康对照组比较，差异无统计学意义(P>0.05);②心肌损伤组的IMA、cTnⅠ、CK-MB 的阳性率高于健康对照组和无心肌损伤组(P<0.05)，而无心肌损伤组和健康对照组比较，差异无统计学意义(P>0.05);心肌损伤组阳性率从高到低依次为IMA 、cTnⅠ、CK-MB，IMA阳性率高于cTnⅠ和CKMB阳性率，统计学意义显著(P<0.01)，cTnⅠ阳性率高于CKMB，统计学意义显著(P<0.01);③三种指标联合检测的阳性率高于单个指标，差异有统计学意义(P<0.05)。结论 IMA 、cTnⅠ和CK-MB联合检测，有助于早期诊断川崎病的心肌损伤。
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关键词：川崎病;心电图;心肌标志物;心肌损伤;儿童
中图分类号：R725.4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.08.032
文章編号：1006-1959(2019)08-0113-03
Abstract：Objective To investigate the diagnostic value of combined detection of myocardial markers in early myocardial injury in children with Kawasaki diseases. Methods A total of 93 children with Kawasaki disease admitted to our hospital from January 2016 to December 2018 were enrolled. According to whether cTnI was positive， 41 patients were divided into myocardial injury group， 52 patients without myocardial injury group， and 45 healthy children who were admitted to the hospital for the same period. Serum iron-deficient albumin (IMA) was detected by albumin-cobalt binding assay， troponinⅠ (cTnⅠ) was detected by chemiluminescence method， and creatine kinase isoenzyme (CK-MB) was determined by immunosuppression. Results ①The levels of IMA， cTnⅠand CK-MB in the myocardial injury group were higher than those in the healthy control group and the non-myocardial injury group (P<0.05)， while the electrocardiogram， IMA， cTnⅠ， CK-MB and healthy controls in the non-myocardial injury group were compared，the difference was not statistically significant (P>0.05). ②The positive rate of IMA， cTnⅠ and CK-MB in myocardial injury group was higher than that in healthy control group and non-myocardial injury group (P<0.05)， but no myocardial injury group and health. There was no significant difference between the two groups (P>0.05). The positive rate of myocardial injury group was IMA， cTnⅠ and CK-MB from high to low. The positive rate of IMA was higher than that of cTnⅠand CKMB， which was statistically significant (P<0.01)， cTnⅠpositive rate was higher than CKMB， statistically significant (P<0.01); ③The positive rate of combined detection of three indicators was higher than single index， the difference was statistically significant (P<0.05). Conclusion The combined detection of IMA， cTnⅠ and CK-MB is helpful for early diagnosis of myocardial injury in Kawasaki diseases., http://www.100md.com(孙昌瑞 冯林)
, http://www.100md.com
关键词：川崎病;心电图;心肌标志物;心肌损伤;儿童
中图分类号：R725.4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.08.032
文章編号：1006-1959(2019)08-0113-03
Abstract：Objective To investigate the diagnostic value of combined detection of myocardial markers in early myocardial injury in children with Kawasaki diseases. Methods A total of 93 children with Kawasaki disease admitted to our hospital from January 2016 to December 2018 were enrolled. According to whether cTnI was positive， 41 patients were divided into myocardial injury group， 52 patients without myocardial injury group， and 45 healthy children who were admitted to the hospital for the same period. Serum iron-deficient albumin (IMA) was detected by albumin-cobalt binding assay， troponinⅠ (cTnⅠ) was detected by chemiluminescence method， and creatine kinase isoenzyme (CK-MB) was determined by immunosuppression. Results ①The levels of IMA， cTnⅠand CK-MB in the myocardial injury group were higher than those in the healthy control group and the non-myocardial injury group (P<0.05)， while the electrocardiogram， IMA， cTnⅠ， CK-MB and healthy controls in the non-myocardial injury group were compared，the difference was not statistically significant (P>0.05). ②The positive rate of IMA， cTnⅠ and CK-MB in myocardial injury group was higher than that in healthy control group and non-myocardial injury group (P<0.05)， but no myocardial injury group and health. There was no significant difference between the two groups (P>0.05). The positive rate of myocardial injury group was IMA， cTnⅠ and CK-MB from high to low. The positive rate of IMA was higher than that of cTnⅠand CKMB， which was statistically significant (P<0.01)， cTnⅠpositive rate was higher than CKMB， statistically significant (P<0.01); ③The positive rate of combined detection of three indicators was higher than single index， the difference was statistically significant (P<0.05). Conclusion The combined detection of IMA， cTnⅠ and CK-MB is helpful for early diagnosis of myocardial injury in Kawasaki diseases., http://www.100md.com(孙昌瑞 冯林)