肌钙蛋白Ⅰ的变化对肺炎心衰患儿的诊断价值

摘要

Objective: To study the pneumonia in children with heart failure of troponin I (cTnI) change and the correlation with cardiac function evaluation.Method: The children with pneumonia in heart failure were selected as the research object,from April 2013 to April 2014 in our hospital.40 cases as pneumonia heart failure group;40 cases as pneumonia of congenital heart failure group(hereinafter referred to as: firsTheart pneumonia group); 40 cases as general pneumonia group; 40 cases of healthy children as normal control group.Enzyme-linked immunosorbent assay (ELISA) for cTnI levels were determined in the peripheral blood application on cardiac function in children with ultrasonic diagnostic instrument,the clinical data was contrasted.Result: Compared normal control group and general pneumonia group with cTnI heart failure group (pneumonia of congenital heart failure group+pneumonia heart failure group) were obviously increased, the difference was statistically significant(P<0.05);PFVP, EF, PFVA, SF, significantly decreased,the difference was statistically significant(P<0.05). The cTnI rise firsTheart pneumonia group, PFVP, PFVA, SF, EF lower than pneumonia heart failure group, but no significant difference (P>0.05). EF falls, elevated cTnI 60 cases, normal 0 case; EF was normal, elevated cTnI 12 cases, 48 cases of normal, elevated cTnI total 72 cases, 48 cases properly. CTnI on EF sensitivity and specificity evaluation were 100% and 80%.Conclusion: Pneumonia in clinical has certain heart function damage, is associated with myocardial damage, of cTnI detection, can damage to myocardium and cardiac function in early diagnosis,to provide accurate reference basis for the establishment of early treatment and prevention for the occurrence of heart failure, to improve the prognosis to a great extent,ensure children survival quality.%目的：探讨肺炎心衰患儿肌钙蛋白I（cTnI）的变化及与心功能评估的相关性。方法：本次选取肺炎心衰患儿作研究对象，均为本院2013年4月-2014年4月收治，其中肺炎心衰组患者40例，先天性心脏病肺炎心衰（简称先心肺炎心衰组）患者40例，一般肺炎组患者40例，对照的健康儿童组40例。应用酶联免疫吸附试验（ELISA）对cTnI在外周血中的含量进行测定，应用超声诊断仪对患儿心功能测定，对比临床资料。结果：与正常对照组、一般肺炎组比较，先心肺炎心衰组和肺炎心衰组cTnI明显升高，PFVP、EF、PFVA、SF明显降低，差异均有统计学意义（P<0.05）。先心肺炎心衰组cTnI升高幅度，PFVP、PFVA、SF、EF降低幅度多于肺炎心衰组，但差异无统计学意义（P>0.05）。EF降低时，cTnI升高60例，正常0例；EF正常时，cTnI升高12例，正常48例，cTnI升高合计72例，正常48例。以EF为金标准，cTnI灵敏度为100%，特异度为80%。结论：肺炎在临床上有一定心功能损害，与心肌损害相关，对cTnI检测，可对心肌、心功能损害早期诊断，为早期治疗方案的制定提供准确的参考依据，对心衰的发生有预防作用，以最大程度的改善预后，保障患儿生存质量。