心肌酶谱、高敏肌钙蛋白在小儿手足口并发心肌炎的诊断

摘要

目的：研究心肌酶谱、高敏肌钙蛋白T（hs-cTnl）在小儿手足口病（HFMD）并发心肌损伤诊断中的临床应用价值。方法143例临床确诊的手足口患儿设为 HFMD 组，并根据心电图检查结果分为心电图正常组（59例）、心电图异常组（84例），选择同期健康体检婴幼儿67例为对照组，比较各组心肌酶谱、cTnT-hs 的变化情况，并研究心电图异常组急性期及恢复期心肌酶谱、cTnT-hs 的变化情况。结果HFMD 心电图异常组心肌酶谱、cTnT-hs 血清浓度及异常率与 HFMD 心电图正常组及对照组比较差异有统计学意义（P ＜0．05），HFMD 心电图正常组与对照组比较差异无统计学意义（P ＞0．05）；HFMD 心电图异常组急性期与恢复期血清浓度 CK、CK-MB、cTnT-hs 差异均有统计学意义（P ＜0．05），AST、LDH 和α-羟基丁酸脱氢酶（α-HBDH）比较差异无统计学意义（P ＞0．05）。结论心肌损伤为 HFMD 患儿较为严重的并发症，临床应以预防为主，对患儿进行心肌酶谱、cT-nT-hs 的监测有重要的临床意义。%Objective To study the clinical application value of myocardial enzymes and troponin in children hand-foot-mouth disease complicating myocardial injury.Methods 143 cases of clinically diagnosed children hand-foot-mouth disease were set as the HFMD group,and divided into the normal group (59 cases)and abnormal electrocardiogram group (84 cases)according to the ECG examination results.Contemporaneous 67 healthy infants and young children with physical examination were selected as the control group.The changes of myocardial enzymes and troponin were compared among various groups.The change situation of myocardial enzymes and troponin during acute and convalescent stages in abnormal ECG group were studied.Results The myocardial en-zymes,serum troponin concentration and the abnormal rate had statistical differences between the HFMD abnormal ECG group with the HFMD normal EKG group and the control group (P <0.05),which had no statistical difference between in the HFMD normal ECG group and the control group (P >0.05);the serum CK,CK-MB cTnT-hs levels had statistical differences between the acute stage and the convalescent stage in the HFMD abnormal EKG group(P <0.05),AST,LDH and α-HBDH had no statistical differ-ences (P >0.05).Conclusion Myocardial injury is more serious complication in children patients with HFMD,clinic should take prevention first,conducting the monitoring of myocardial enzymes and troponin has important clinical significance.