Clark Simon J, Eisenhut Michael, Sidaras Dorothea, Hancock Stephen W, Newland Paul, Thorburn Kent
Royal Liverpool Children's NHS Trust, Eaton Road, Liverpool L12 2AP, UK.
Crit Care. 2006;10(5):R128. doi: 10.1186/cc5040.
Cardiac troponin T (cTnT) has been used to assess prevalence of myocardial injury in critically ill children. The majority of studies investigated patients undergoing cardiac surgery. Myocardial injury has been associated with increased mortality. Our objectives were to investigate whether cTnT levels are elevated in infants without congenital heart disease admitted to the paediatric intensive care unit (PICU) and whether levels are associated with increased disease severity.
We measured cTnT in consecutive infants (<12 months old) without congenital heart disease admitted to the PICU and healthy infants. The Paediatric Index of Mortality (PIM) score was determined in patients on the PICU.
We recruited 107 infants: 47 infants admitted to the PICU and 60 healthy controls. Controls were, with a median (interquartile range (IQR)) age of 20 (12 to 34) weeks, significantly older than cases, with a median age of 6.5 (0.3 to 20.6) weeks. CTnT levels were, with a median (IQR) of 18 (10 to 60) pg/ml, significantly higher in admissions to the PICU than in controls, with a median level of 10 (10 to 10) pg/ml (95th centile of 20 pg/ml) (p < 0.001). There was a significant positive correlation (r = 0.41, p = 0.004) between PIM score and cTnT levels. Admissions under one month old had higher cTnT levels than older patients (p = 0.013) but the PIM score was not significantly different between them. When corrected for age and weight the correlation of PIM and cTnT was no longer significant.
Infants on the PICU in the neonatal period have higher cTnT levels compared to older infants despite not having more severe disease.
心肌肌钙蛋白T（cTnT）已被用于评估危重症儿童心肌损伤的患病率。大多数研究调查了接受心脏手术的患者。心肌损伤与死亡率增加有关。我们的目的是调查入住儿科重症监护病房（PICU）的无先天性心脏病婴儿的cTnT水平是否升高，以及这些水平是否与疾病严重程度增加相关。
我们测量了入住PICU的连续无先天性心脏病婴儿（<12个月）和健康婴儿的cTnT。对入住PICU的患者确定了儿科死亡率指数（PIM）评分。
我们招募了107名婴儿：47名入住PICU的婴儿和60名健康对照。对照组的中位（四分位间距（IQR））年龄为20（12至34）周，明显大于病例组，病例组的中位年龄为6.5（0.3至20.6）周。入住PICU患者的cTnT水平中位（IQR）为18（10至60）pg/ml，明显高于对照组，对照组的中位水平为10（10至10）pg/ml（第95百分位数为20 pg/ml）（p<0.001）。PIM评分与cTnT水平之间存在显著正相关（r = 0.41，p = 0.004）。1个月以下的入住患者的cTnT水平高于年龄较大的患者（p = 0.013），但他们之间的PIM评分无显著差异。校正年龄和体重后，PIM与cTnT的相关性不再显著。
新生儿期入住PICU的婴儿与年龄较大的婴儿相比，cTnT水平更高，尽管疾病并不更严重。
