Chong Debbra, Chua Yan Ting, Chong Shu-Ling, Ong Gene Yong-Kwang
Children's Emergency, KK Women's and Children's Hospital, Singapore, Singapore.
Pediatr Cardiol. 2018 Dec;39(8):1530-1534. doi: 10.1007/s00246-018-1925-5. Epub 2018 Jun 19.
Troponin I is a cardiac enzyme that is released during myocardial injury. However, cardiac enzymes are non-specific and can occur in many cardiac and non-cardiac pathologies. We aim to (1) describe the range of acute conditions that were associated with raised troponins in the paediatric population in our institution and (2) quantify the extent of troponin elevation and correlate it with the underlying aetiology. We performed a retrospective observational study in a tertiary institution which included patients from 1 January 2009 to 31 December 2013. We identified patients with troponin I levels of more than 0.1 ng/ml who have not had cardiac surgery before. We recorded their final diagnoses, and then compared the peak troponin levels and the eventual final diagnoses. We identified 100 patients. The top few common diagnoses resulting in a raised troponin were sepsis (29%), cardiac pathologies (29%) such as tachyarrhythmias and cardiomyopathies and myocarditis (21%). Other pathologies included trauma and other causes of multiorgan dysfunction. The median peak troponin I was higher in cardiac as compared to non-cardiac pathologies: 2.15 (0.52-15.0) and 0.44 (0.21-1.68), respectively. There was no statistically significant difference in the peak troponin I values in the presence of hypotension or renal impairment. We described the range of conditions that may result in raised troponin I levels. The extent of raised troponin I levels may potentially be useful in differentiating between cardiac and non-cardiac pathologies. However, further studies on a larger scale are required to establish whether extent of troponin I elevation has a diagnostic role for cardiac pathologies.
肌钙蛋白I是一种在心肌损伤时释放的心脏酶。然而，心脏酶是非特异性的，可出现在许多心脏和非心脏疾病中。我们旨在：（1）描述在我们机构的儿科人群中与肌钙蛋白升高相关的急性病症范围；（2）量化肌钙蛋白升高的程度，并将其与潜在病因相关联。我们在一家三级医疗机构进行了一项回顾性观察研究，研究对象包括2009年1月1日至2013年12月31日期间的患者。我们确定了肌钙蛋白I水平超过0.1 ng/ml且之前未进行过心脏手术的患者。我们记录了他们的最终诊断结果，然后比较了肌钙蛋白峰值水平和最终诊断结果。我们确定了100名患者。导致肌钙蛋白升高的最常见的几种诊断包括败血症（29%）、心脏疾病（29%），如快速心律失常、心肌病和心肌炎（21%）。其他病症包括创伤和多器官功能障碍的其他原因。与非心脏疾病相比，心脏疾病患者的肌钙蛋白I峰值中位数更高：分别为2.15（0.52 - 15.0）和0.44（0.21 - 1.68）。在存在低血压或肾功能损害的情况下，肌钙蛋白I峰值水平没有统计学上的显著差异。我们描述了可能导致肌钙蛋白I水平升高的病症范围。肌钙蛋白I水平升高的程度可能有助于区分心脏和非心脏疾病。然而，需要进行更大规模的进一步研究，以确定肌钙蛋白I升高的程度对心脏疾病是否具有诊断作用。
