心肌肌钙蛋白-I在病毒性心肌炎诊断及预后判断中的应用

目的　探讨心肌肌钙蛋白 I(cTnI)在病毒性心肌炎诊断及预后判断中的应用。方法　选择病毒性心肌炎患者 85例 ,测定血清cTnI及肌酸激酶 MB同工酶 (CK MB) ,长期随访观察cTnI;采用超声心动图测定 ,观察心脏大小及心室功能变化。结果　①cTnI诊断病毒性心肌炎阳性率显著高于CK MB。②将患者按入院时cTnI水平由低至高分为 <0 .2 5 μg·L- 1 组 ,0 .2 5～<1 0 μg·L- 1 组及≥ 1 0 μg·L- 1 组 ,随着血清cTnI浓度的升高 ,左室舒张末内径 (LVDd)逐渐增大 ,射血分数 (EF)逐渐降低 ;随访期 ,随着入院时血清cTnI水平的由低至高 ,LVDd显著增大而EF显著降低 (P <0 .0 5 )。结论　①cTnI作为心肌损伤指标优于CK MB。②病毒性心肌炎患者 ,cTnI水平高低与患者心脏大小以及远期心室功能发展有关 ,cTnI增高者心室腔扩大而心室功能下降

The role of serum cardiac troponin-I in the diagnosis and prognosis estimation in patients with viral myocarditis

Objective To determine the role of serum cardiac troponin I (cTnI) in the diagnosis and prognosis estimation in patients with viral myocarditis.Methods Serum cTnI and creatine kinase isoenzyme MB (CK MB) were detected in 85 patients. Enlargment and function of the ventricle were assessed by echocardiography. The level of cTnI and ventricular function were measured at follow up.Results ①The positive rate of serum cTnI was significantly higher than that of CK MB in the diagnosis of viral myocarditis (73.1% VS 13.2% P <0.01). ②Patients were divided into three groups according to the level of serum cTnI, namely cTnI<0.25?ng·mL -1 , 0.25～<10?ng·mL -1 and ≥10?ng·mL -1 . With the rise of cTnI level, the left ventricular diastolic diameter (LVDd) showed a significant increase ( P <0.05), but ejection fraction (EF) showed significant reduction at follow up ( P <0.05).Conclusion ①As a serum marker for cardiac injury, serum cTnI is superior to CK MB. ②The level of serum cTnI is associated with the development of deterioration of ventricular function. High level of cTnI means enlargment of the left ventricle but decline in EF.