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肌钙蛋白T:改善儿童期心肌损伤的诊断评估

Troponin-T: improved diagnostic assessment of myocardial damage in childhood.

作者信息

Immer F F, Stocker F, Seiler A M, Pfammatter J P, Printzen G, Peheim E

机构信息

Division of Paediatric Cardiology, University Hospital, Berne, Switzerland.

出版信息

Acta Paediatr. 1997 Dec;86(12):1321-7. doi: 10.1111/j.1651-2227.1997.tb14906.x.

Abstract

Troponin-T (cTnT) as a marker of myocardial damage is well established in adults, but not yet in children. cTnT was measured in 85 children (aged 1 day-204 months, mean 46 months). Twenty-five children were non-surgical patients, with possible myocardial damage suspected on clinical grounds. The other 60 patients had cardiac surgery leading to a defined myocardial damage. In these children, troponin-T (cTnT), creatine kinase activity (CK), creatine kinase-MB activity (CK-MB), and creatine kinase-MB-Mass (CK-MB-Mass) were measured preoperatively and 3-4 times during the first 55 postoperative h. Except in four children with probable preoperative myocardial damage, all troponin-T values were in the normal range (< 0.1 microg/l). All children with intracardiac surgery showed a postoperative increase in troponin-T. Children with extracardiac surgery of the great vessels showed no postoperative increase of troponin-T. For the assessment of myocardial damage, troponin-T was more specific and more sensitive than the other markers tested, troponin-T might significantly improve the diagnostic assessment of myocardial damage in children.

摘要

肌钙蛋白T(cTnT)作为心肌损伤的标志物在成人中已得到充分确立,但在儿童中尚未如此。对85名儿童(年龄1天至204个月,平均46个月)进行了cTnT检测。25名儿童为非手术患者,临床上怀疑可能有心肌损伤。另外60名患者接受了心脏手术,导致明确的心肌损伤。对这些儿童在术前以及术后55小时内3至4次测量肌钙蛋白T(cTnT)、肌酸激酶活性(CK)、肌酸激酶MB活性(CK-MB)和肌酸激酶MB质量(CK-MB-Mass)。除了4名术前可能有心肌损伤的儿童外,所有肌钙蛋白T值均在正常范围内(<0.1微克/升)。所有接受心脏内手术的儿童术后肌钙蛋白T均升高。接受大血管心脏外手术的儿童术后肌钙蛋白T未升高。对于心肌损伤的评估,肌钙蛋白T比所检测的其他标志物更具特异性和敏感性,肌钙蛋白T可能会显著改善儿童心肌损伤的诊断评估。

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