论文部分内容阅读
目的探讨血清心脏肌钙蛋白Ⅰ(cTnⅠ)对手足口病(HFMD)患儿时心肌损害的诊断价值及疾病预防对策。方法选取本院2014年5月至2016年11月收治的85例手足口病患儿作为观察组;将其中合并心肌损害的患儿42例归为心肌损害亚组,心肌正常的患儿43例归为心肌正常亚组。另选取相同年龄段体检健康者80例作为对照组。抽取所有受检者空腹静脉血,分别采用乳胶增强免疫比浊法及免疫抑制法检测cTnⅠ、肌酸激酶同工酶(CKMB)水平。比较两组及观察组各亚组患儿cTnⅠ、CK-MB表达水平,分析cTnⅠ、CK-MB诊断小儿HFMD心肌损害的灵敏度、特异度、准确度。结果观察组cTnⅠ、CK-MB水平高于对照组,差异有统计学意义(均P<0.05);并发心肌损害患儿cTnⅠ、CK-MB水平高于心肌正常患儿,差异有统计学意义(均P<0.05);cTnⅠ诊断HFMD心肌损害的敏感度为92.86%(39/42)、特异度为95.35%(41/43)、准确度为94.12%(80/85),均高于CK-MB的76.19%(32/42)、79.07%(34/43)、77.65%(66/85),差异有统计学意义(均P<0.05)。结论 cTnⅠ有助于及早发现小儿HFMD心肌损害,诊断敏感度、特异度及准确度较高。需同时注重家庭、医院对HFMD的预防作用,积极向学校、社区开展宣教工作。
Objective To investigate the diagnostic value of serum cardiac troponin Ⅰ (cTnⅠ) in myocardial damage in children with hand-foot-mouth disease (HFMD) and its preventive strategies. Methods Eighty-five children with hand-foot-mouth disease admitted from May 2014 to November 2016 in our hospital were selected as the observation group. Forty-two children with myocardial damage were classified as subgroup of myocardial damage, and 43 cases of normal myocardium As a normal subgroup of myocardium. Another selected the same age group of 80 healthy subjects as a control group. Fasting venous blood was collected from all the subjects, and cTnI and CKMB levels were measured by latex-enhanced immunoturbidimetric assay and immunosuppressive assay. The levels of cTnI and CK-MB in children in both subgroups and the control group were compared. The sensitivity, specificity and accuracy of cTnI and CK-MB in diagnosing HFMD myocardial damage were analyzed. Results The levels of cTnⅠ and CK-MB in the observation group were significantly higher than those in the control group (all P <0.05). The levels of cTnⅠ and CK-MB in children with myocardial damage were significantly higher than those in the normal control group (P < (P <0.05). The sensitivity and specificity of cTnⅠ in diagnosing HFMD were 92.86% (39/42), 95.35% (41/43) and 94.12% (80/85) MB were 76.19% (32/42), 79.07% (34/43) and 77.65% (66/85), respectively, with significant difference (all P <0.05). Conclusions cTnI can help early detection of HFMD myocardial damage in children with high diagnostic sensitivity, specificity and accuracy. At the same time, we should pay attention to the preventive effect of family and hospitals on HFMD, and actively carry out mission education to schools and communities.