缺血修饰性清蛋白对传染性单核细胞增多症患儿心肌损伤的诊断价值  

Clinical value of ischemia modified albumin in the diagnosis of myocardial injury in children with infectious mononucleosis

作　　者：冯林 孙昌瑞[2] 

机构地区：[1]四川省妇幼保健医院检验科,成都610091 [2]四川省医学科学院/四川省人民医院检验科,成都610072

出　　处：《检验医学与临床》2016年第12期1648-1649,共2页Laboratory Medicine and Clinic

摘　　要：目的探讨缺血修饰清蛋白(IMA)对传染性单核细胞增多症患儿心肌损伤的诊断价值。方法选取2014年3月至2015年3月在四川省妇幼保健医院住院的122例传染性单核细胞增多症患儿(41例有心肌损伤,81例无心肌损伤)和健康对照者40例,采用清蛋白-钴结合能力试验测定血清IMA,采用时间分辨免疫荧光法检测心型脂肪酸结合蛋白(H-FABP),采用微粒子化学发光免疫法检测肌钙蛋白I(cTnI),采用免疫抑制法测定肌酸激酶同工酶(CK-MB)。结果 (1)有心肌损伤组H-FABP、cTnI、CK-MB水平明显高于健康对照组和无心肌损伤组(P<0.05),IMA则低于后两组(P<0.05);无心肌损伤组IMA、HFABP、cTnI、CK-MB和健康对照组比较差异无统计学意义(P>0.05);(2)有心肌损伤组IMA、H-FABP、cTnI、CK-MB阳性率明显高于健康对照组和无心肌损伤组(P<0.05),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),有心肌损伤组按照阳性率从高到低为cTnI、IMA、H-FABP、CK-MB。结论敏感度高的IMA和特异性强的cTnI联合检测,有利于早期诊断传染性单核细胞增多症的缺血性心肌损伤。Objective To investigate the value of ischemia modified albumin（IMA）in the diagnosis of myocardial injury in children with infectious mononucleosis.Methods From March 2014 to March 2015,122 cases of infectious mononucleosis in children（41cases with myocardial injury,81 cases without myocardial injury）and 40 cases of healthy controls were collected,the serum IMA were detected by albumin cobalt binding test,H-FABP were detected by time resolved fluorescence immunoassay,cTnI were detected by microparticle chemiluminescence immunoassay and CK-MB were detected by immuno-suppression.Results（1）cTnI,CK-MB and H-FABP levels in myocardial injury group were significantly higher than those in healthy control group and non myocardial injury group（P〈0.05）,IMA was lower than the latter two groups（P〈0.05）.While there was no significant difference in IMA,cTnI,H-FABP,CK-MB between healthy control group and non myocardial injury group（P〈0.05）.（2）The positive rate of CK-MB,H-FABP,cTnI and IMA in myocardial injury group was significantly higher than that in healthy control group and non myocardial injury group（P〈0.05）,there was no significant difference between healthy control group and non myocardial injury group（P〉0.05）.In the myocardial injury group,the positive rate was from high to low,cTnI〉IMA〉H-FABP〉CK-MB.Conclusion Combined IMA with high sensitivity and cTnI with high specificity is helpful for early diagnosis of IMA in patients with infection mononucleosis.

关 键 词：缺血修饰清蛋白 传染性单核细胞增多症 心肌损伤 儿童 

分 类 号：R512.7[医药卫生—内科学]