|
ObjectiveIn clinic, we often find many children, whose myocardial enzyme creatine kinase muscle B activity(CK-MB Act) increased with or not creatine kinase (CK) increased, were diagnosed myocardial damage even myocarditis without electrocardiography (ECG) or echocardiography (PDE) abnormal found and were over-treated. In this article, creatine kinase muscle B mass (CK-MB Mass)was determined among those children with myocarditis, myositis, hand-foot and mouth disease (HFMD), herpes angina and short breath, then compared it with cardiac troponin I (cTnI), the Gold Standard at myocardial damage, to assess its diagnostic significance at myocardial injury.Methods1.Case Selection:children were selected from the Shengjing Hospital of China Medical University pediatric cardiovascular professional out-patient and in-patient with myocarditis(3 males,4 females, aged 0.3-12 years, average:5.80±4.96), myositis(29 males,12 females, aged 0.6-13 years, average:5.21±3.41), HFMD (20 males,13 females, aged 1-5 years, average:2.74±1.11), herpes angina (8 males,5 females, aged 1-5 years, average:2.92±1.18) and short breath(36 males,33 females, aged 5-12 years, average:8.34±1.73).Their serum were measured CK, CK-MB activity, CK-MB mass, cTnI, ECG, echocardiography (cardiac structure and left ventricular systolic function). At the same time 10 health check children were chose as a control from developing pediatric out-patient, as well as physical dwarf of unknown reason, whose CK, CK-MB Act, CK-MB Mass, cTnI were measured; Furthermore, in the short breath group the original of food-respiratory allergy and the total IgE were determined, while myoglobin and electromyography(EMG) were determined in myositis group. 2.Experimental Method:CK, CK-MB Act was determined by the United States Johnson & Johnson produced VITROS950-based biochemical analyzer, CK-MB Mass, cTnI were determined by Access-based biochemical analyzer made in the German BECKMAN company’s, myoglobin used by the U.S. Beckman coulter immune analyzer. The reagents used by their respective instruments of production companies.ECG-9320K made in Japan. PHILIPS IE33, S5-1or S12-4 Echocardiography made in NetherlandsAirway provocation test: Use the Power Cube pulmonary function instrument made in German Ganshorn company.EMG:Nicolet Company Vikingquest standard EMG evoked potential instrument.All experiments were operated by professional technicians and professional physicians in order to ensure data accurate and reliable.Results1.myocarditis group:CK increased 3/7, CK-MB Act increased 4/7, CK-MB mass increased 4/5, troponin I increased 7/7, p<0.05, compare to control, showed significant difference.2.myositis group:CK increased 40/41, CK-MB activity increased 36/41, CK-MB Mass increased 25/41, cTnI increased 1/41, myoglobin increased 9/24, p<0.05, compare to control, showed significant difference.3.HFMD group:CK increased 6/33, CK-MB Act increased 25/33, CK-MB Mass increased 3/33, cTnI increased 0/33, p<0.05, compare to control, showed significant difference.4.herpetic angina group:CK increased 2/13, CK-MB Act increased 6/13, CK-MB Mass increased 1/13, cTnI increased 1/13, p<0.05, compare to control, showed significant difference.5.short breath group:CK increased 7/69, CK-MB Act increased 14/69, CK-MB Mass increased 0/69, cTnI increased 2/69, p<0.05, showed significant difference.ConclusionsIn ischemic and infectious myocardial damage, the sensitivity of CK-MB Mass is higher than that of cTnl, the specificity of CK-MB mass is higher than that of CK-MB activity but lower than that of cTnl.The test of CK-MB mass is a necessary complementary way to diagnose myocardial damage in those patients without skeletal muscle damage.
|