血清CK、CK—MB、cTnI对婴幼儿患者心肌损害诊断的临床研究

目的探讨婴幼儿患者血清、CK—MB及cTnI对心肌损害的诊断价值。方法对196例和102例心电图和临床表现有、无心肌损害表现的婴幼儿患者和正常对照儿童进行血清CK、CK—MB及cTnI测定。结果有心肌损害组三项指标分别为CK（236．2±127．2）U／L；CK—MB（32．2±12．7）U／L；cTnI（0．24±0．13）ng／ml，均明显高于无心肌损害表现组及正常对照组（P〈0．01），但特异性和敏感性却不尽相同，联合检验的敏感性及准确性达93．4％和80．5％，均有显著提高（P〈0．05）。结论血清CK、CK—MB及cTnI在对婴幼儿患者心肌损害反映中，CK、CK—MB特异性不高，同时要考虑到单纯CK、CK—MB活性增高可能是生理、标本和试剂等因素所致，不具有临床诊断价值；cTnI特异性最高，但在心肌轻度损害时敏感性不高；因此诊断婴幼儿患者心肌损害时应联合这三项并结合心电图和临床表现来综合确定诊断。

Clinical study on myocardial injury diagnosis of the serum CK, CK-MB, cTnI to the infant patients

Objective To explore the diagnostic value of serum CK, CK-MB, cTnI to myocardial injury in the infant patients. Methods Determination was made to serum CK, CK - MB and cTnI for 196 examples and 102patients with electrocardiogram and clinical expression with and without a myocardial impairment performance of no myocardial injury patients and normal children as control. Results Three indexes of the myocardial injury group were CK (236.2 ± 127.2) U/L; CK-MB (32.2 ± 12.7) U/L, cTnI (0.24 ± 0.13) ng/ml respectively, significantly higher than those in the group without myocardial impairment performance and control group(P ＜ 0.01), but the specificity and sensitivity were different, and the sensitivity and accuracy of the Joint inspection attained 93.4% and 80.5%, both data fields had significant improves (P ＜ 0.05). Conclusions The reaction of the serum CK, CK-MB and the cTnI for infant patients myocardial injury showed that CK, CK-MB specificity is not high, at the same time,we should consider the activity increasing of the pure CK, CK-MB may result from physiology, specimens and reagents, without clinical diagnostic value. The cTnI has the highest specificity, but in myocardial mild damage the sensitivity is not high, so the diagnosis to infant patients myocardial injury should combine with these three factors, as well as the electrocardiogram and clinical expression for comprehensive confirmation.