抗心肌抗体在小儿病毒性心肌炎诊断中的价值及意义

发布时间：2019-03-28 18:12

【摘要】：目的:分析病毒性心肌炎(VMC)患儿抗心肌抗体(AHA)的检测结果,明确AHA在小儿VMC诊断中的作用。方法:采用前瞻性分析方法,入选62例VMC患儿为VMC组,同期46例疑似VMC患儿为疑似VMC组,20名健康儿童设为对照组,采用酶联免疫吸附法对各组4种AHA[抗心肌线粒体ADP/ATP载体蛋白(ANT)抗体、抗β1-受体抗体、抗M2胆碱能(M2)受体抗体、抗肌球蛋白重链(MHC)抗体]的结果进行分析和比较。结果:VMC组4种AHA的阳性率均高于对照组,差异有显著统计学意义(P0.01),疑似VMC组4种AHA的阳性率亦高于对照组,差异有统计学意义(P0.05)。VMC组与疑似VMC组间差异有统计学意义(P0.05)。抗ANT抗体、抗β1-受体抗体、抗M2受体抗体、抗MHC抗体在VMC患儿中检测的灵敏度分别为91.9%、93.5%、90.3%、93.5%,特异度分别为85%、80%、85%、85%。11例暴发性心肌炎患儿4种AHA的阳性率分别为81.8%、90.9%、81.8%、81.8%。结论:AHA对小儿VMC的诊断具有较高的特异性和敏感性,检测结果与临床诊断高度一致,临床上可为VMC的诊断及免疫治疗提供依据。
[Abstract]:Objective: to analyze the results of detection of anti-myocardial antibody (AHA) in children with viral myocarditis (VMC) and to determine the role of AHA in the diagnosis of VMC in children. Methods: 62 children with VMC were enrolled as VMC group, 46 children with suspected VMC as suspected VMC group and 20 healthy children as control group. Enzyme-linked immunosorbent assay (Elisa) was used to detect four kinds of AHA (anti-cardiac mitochondrial ADP/ATP vector (ANT) antibody, anti-尾 1-receptor antibody and anti-M2 cholinergic receptor antibody). The results of anti-myosin heavy chain (MHC) antibody were analyzed and compared. Results: the positive rate of four kinds of AHA in VMC group was significantly higher than that in control group (P0.01). The positive rate of four kinds of AHA in suspected VMC group was also higher than that in control group. The difference was statistically significant (P0.05) between). VMC group and suspected VMC group (P0.05). The sensitivity of anti-ANT antibody, anti-尾 1-receptor antibody, anti-M2 receptor antibody and anti-MHC antibody in children with VMC was 91.9%, 93.5%, 90.3%, 93.5%, respectively. The specificity was 85%, 80%, 85%, respectively. The positive rates of four kinds of AHA were 81.8%, 90.9%, 81.8% and 81.8% in 11 cases of fulminant myocarditis, respectively. Conclusion: AHA has high specificity and sensitivity in the diagnosis of VMC in children, and the results are highly consistent with the clinical diagnosis. It can provide the basis for the diagnosis and immunotherapy of VMC.
【作者单位】：华中科技大学同济医学院附属武汉儿童医院心内科;
【基金】：武汉市卫生计生科研基金(No:WX17B08)
【分类号】：R725.4

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