病毒性心肌炎患儿血清IMA、h-FABP 水平变化及与心肌损害的相关性

The level of serum IMA and h-FABP in children with viral myocarditis and its correlation with myocardial damage

摘要:

目的 探讨病毒性心肌炎患儿血清缺血修饰白蛋白（IMA）、心型脂肪酸结合蛋白（h-FABP） 水平变化，并分析血清IMA、h-FABP 水平与心肌损害的相关性。方法 选取2016 年10 月—2019 年10 月 在绵阳市中心医院确诊的病毒性心肌炎患儿96 例作为观察组，根据临床表现和相关检查，将观察组分为轻症 组（54 例）和重症组（42 例）。选取同期该院健康体检儿童50 例作为对照组。采用白蛋白钴结合试验检测 血清IMA 浓度，酶联免疫吸附试验检测血清h-FABP 水平，化学发光免疫分析法测定血清心肌肌钙蛋白I 水 平。采用Pearson 法分析血清IMA、h-FABP 水平与心肌损害的相关性。结果 观察组血清IMA、h-FABP 水平较对照组高（P <0.05）。重症组血清IMA、h-FABP 水平较轻症组高（P <0.05）。病毒性心肌炎患儿血 清心肌肌钙蛋白I 水平为（0.26±0.12）ng/ml。病毒性心肌炎患儿血清IMA、h-FABP 水平与心肌肌钙蛋白I 水平呈正相关（r =0.803 和0.851，P <0.05）。结论 病毒性心肌炎患儿存在血清IMA、h-FABP 的高表达， 血清IMA、h-FABP 水平随病情严重程度的增加而升高，且与心肌损伤程度呈正相关，具有良好的临床早期 诊断及病情评估价值。

Abstract:

Objective To investigate the changes in serum ischemic modified albumin (IMA) and heart-type fatty acid binding protein (h-FABP) levels in children with viral myocarditis (VMC), and to analyze the correlation between serum IMA and h-FABP levels and myocardial damage. Methods A total of 96 children with VMC confirmed in our hospital from October 2016 to October 2019 were selected as the observation group. According to the clinical manifestations and related inspections, the observation group was divided into the mild group (n = 54) and the severe group (n = 42). Another 50 children undergoing health examination in the same period were selected as the control group. The albumin-cobalt binding test was used to detect the concentration of IMA in serum. The enzymelinked immunosorbent assay was used to detect the level of serum h-FABP. The chemiluminescence immunoassay was used to detect the level of serum cardiac troponin I (cTnI). Besides, the correlation between the levels of serum IMA and h-FABP and myocardial damage was explored by Pearson correlation analysis. Results The levels of serum IMA and h-FABP in the observation group were significantly higher than those in the control group (P < 0.05), while the levels of serum IMA and h-FABP in the severe group were higher than those in the mild group (P < 0.05).Pearson correlation analysis showed that there was a positive correlation between the levels of serum IMA (r = 0.803), h-FABP (r = 0.851) and cTnI in children with VMC (P < 0.05). Conclusions There is high expression of IMA and h-FABP in children with VMC, and the levels of serum IMA and h-FABP in children with VMC increase with the severity of the disease and are positively correlated with the degree of myocardial damage, which is of significance in clinical early diagnosis and disease evaluation.