心肌肌钙蛋白T检测及其在病毒性心肌炎诊断中的价值  

To explore the role of serum cardic troponin T in the diagnosis and observation in patients with viral myocarditis

作　　者：谭艳[1] 韩晓芳[1] 贾向东[2] 王虹[1] 侯巍[1] 张秀屏[1] 宿俊彪[1] 

机构地区：[1]内蒙古自治区医院检验科,呼和浩特010017 [2]内蒙古自治区医院肿瘤科,呼和浩特010017

出　　处：《中华检验医学杂志》2005年第9期905-908,共4页Chinese Journal of Laboratory Medicine

基　　金：内蒙古自治区科技攻关资助项目(20010213)

摘　　要：目的探讨肌钙蛋白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102例急性病毒性心肌炎患者进行入院后1、2、3周及3个月cTnT和心肌酶谱的动态研究;cTnT阳性率与心内膜心肌活检(EMB)病理检查诊断率的对照研究;cTnT与心电图(ECG)、及病程关系的研究。结果急性病毒性心肌炎患者在各检测期内血清cTnT的阳性率(45.1%,)较心肌酶谱各项目[肌酸激酶(CK)29.4%、肌酸激酶同工酶(CKMB)34.3%、门冬氨酸氨基转移酶(AST)10.9%、乳酸脱氢酶(LDH)13.7%、α羟丁酸脱氢酶(αHBDH)12.8%]显著增高(P<0.005,P<0.05);cTnT阳性率(45.1%,46/102)与心内膜心肌活检病理诊断率(40.6%,13/32)差异无统计学意义(P>0.05);cTnT阳性组ECG正常率(8.7%,4/46)明显低于阴性组(25%,14/56)(P<0.05);cTnT阳性组3个月的总治愈率(65.2%,30/46)明显低于阴性组(89.3%,50/56)(P<0.005)。结论在病毒性心肌炎的诊断中cTnT可取代传统的心肌酶谱测定;cTnT具有与心内膜心肌活检同样重要的诊断价值;cTnT在病毒性心肌炎病情观察中也具有重要意义。Objective To investigate the value of cardic troponin T （cTnT）in the diagnosis and observation in patients with viral myocarditis. （VMC）. Methods Serum cTnT and cardiac enzymes were measured in 102 patients with acute VMC at different stages （ admission, 1 week, 2 weeks, 3 weeks, 3 months）; Comparition study were performed between the positive rate of cTnT with diagnosis rate of endomyocardial biopsy（EMB） ; The realations of cTnT with electrocardiograph（ECG） and course of disease were studied. Results The positive rate of cTnT was significantly higher than cardiac enzyme levels at different stages （ P 〈 0. 005, P 〈 0. 05 ） ; There is no significant difference between the positive rate of cTnT with diagnosis rate of EMB（P 〉0. 05 ）. The normal rate of ECG in positive group was significantly lower than negative group （ P 〈 0. 05 ）. The cure rate in positive group was significantly lower than in negative group at 3 months （ P 〈 0. 005 ）. Conclusions Measurement of serum levels of cTnT provides evidence of myocyte injury in patients with VMC more sensitively and specifically than does convention determination of cardiac enzyme levels;cTnT and EMB are very important in diagnosis of VMC;Cadic damage in positive group were more severe than in negative group, cTnT also plays an important role in the observation in patients with VMC.

关 键 词：肌钙蛋白 心肌炎 心内膜 急性病毒性心肌炎 心肌肌钙蛋白T检测 诊断价值 诊断率 心内膜心肌活检 肌酸激酶同工酶 门冬氨酸氨基转移酶 

分 类 号：R542.21[医药卫生—心血管疾病] R542.22[医药卫生—内科学]