Charles University in Prague, Faculty of Medicine in Pilsen, Faculty Hospital, Department of Paediatrics, Pilsen, Czech Republic.
Physiol Res. 2021 Mar 17;70(1):27-32. doi: 10.33549/physiolres.934453. Epub 2021 Jan 14.
Cardiac troponin T determination plays a dominant role in diagnosis of myocardial pathologies. Despite generally accepted use of high-sensitive cardiac troponin T assays (hscTnT) and clearly defined cut-off limit in adults, the uncertainty persists in infants. The aim of this study was to assess plasmatic concentrations of hscTnT and describe sequential age-related dynamic changes of hscTnT in healthy infants and toddlers. Seventy-eight children (52 males/26 females) from Czech Republic aged 44 to 872 days (median, interquartile range 271; 126 to 486 days) were consecutively enrolled in the single-center, prospective observational study. Plasma concentrations of hscTnT were analyzed by the electrochemiluminescent method, age-related reference intervals were calculated using the polynominal regression model. Amongst the study population (n=78), the upper limit of hscTnT concentration defined as the 99th percentile was calculated. The 99th percentile with 95 % confidence interval at the end of 2nd, 3rd, 4th, 5th, 6th and 7th month of postnatal life were: 81 (40.6 to 63.6), 61 (36.0 to 55.3), 47 (31.9 to 48.3), 37 (28.1 to 42.3), 30 (24.7 to 37.2) and 25 (21.5 to 32.7) ng/l, respectively. Concentration of adults 99th percentile (14 ng/l) was achieved approximately at 1 year of postnatal life. Statistically significant negative correlation of hscTnT concentration with age (r=-0.81, p<0.001) was found. Significant gender differences were not found (p>0.07). The study revealed substantially increased reference intervals of hscTnT levels in infants when compared with adult population. Based on our preliminary results, the age-related interpretation of hscTnT plasmatic concentration is recommended.
心肌肌钙蛋白 T 测定在诊断心肌病变中起着主导作用。尽管高敏心肌肌钙蛋白 T 测定（hs-cTnT）已被广泛应用，且在成年人中明确界定了截断值，但在婴儿中仍存在不确定性。本研究旨在评估 hs-cTnT 的血浆浓度，并描述健康婴儿和幼儿中与年龄相关的 hs-cTnT 动态变化。
我们连续纳入了来自捷克共和国的 78 名年龄为 44 至 872 天（中位数，四分位距 271；126 至 486 天）的儿童（52 名男性/26 名女性），进行了一项单中心前瞻性观察研究。采用电化学发光法分析 hs-cTnT 血浆浓度，使用多项式回归模型计算与年龄相关的参考区间。
在研究人群（n=78）中，定义第 99 百分位数作为 hs-cTnT 浓度的上限。第 2、3、4、5、6 和 7 个月时的第 99 百分位数（95%置信区间）分别为：81（40.6 至 63.6）、61（36.0 至 55.3）、47（31.9 至 48.3）、37（28.1 至 42.3）、30（24.7 至 37.2）和 25（21.5 至 32.7）ng/L。成年人群第 99 百分位数（14ng/L）在出生后约 1 年达到。发现 hs-cTnT 浓度与年龄呈显著负相关（r=-0.81，p<0.001）。未发现显著的性别差异（p>0.07）。
本研究表明，与成人人群相比，婴儿 hs-cTnT 水平的参考区间显著增加。基于我们的初步结果，建议对 hs-cTnT 血浆浓度进行与年龄相关的解释。
