特异性抗心肌抗体对小儿心肌疾病的诊断价值

Diagnostic value of specific antiheart autoantibodies in children with cardiomyopathy

摘要:

目的探讨抗心肌ＡＤＰ／ＡＴＰ载体（ＡＮＴ）和肌球蛋白抗体两种特异性抗心肌抗体（ＡＨＡ）对小儿心肌疾病的诊断价值。方法运用免疫印转法和酶联免疫吸附法检测了３０例病毒性心肌炎（ＶＭＣ），１４例扩张型心肌病（ＤＣＭ）患儿血浆抗ＡＮＴ和抗肌球蛋白两种特异性ＡＨＡ水平。结果抗ＡＮＴ抗体和抗肌球蛋白抗体两种ＡＨＡ在ＶＭＣ和ＤＣＭ患儿中的阳性率均显著高于正常对照组（Ｐ均＜０．０５）。抗ＡＮＴ抗体诊断ＶＭＣ和ＤＣＭ的敏感性为７２．７３％，特异性为１００％。抗肌球蛋白抗体诊断ＶＭＣ和ＤＣＭ的敏感性为５４．５５％，特异性为９６％。结论抗ＡＮＴ抗体和抗肌球蛋白抗体均可作为小儿ＶＭＣ和ＤＣＭ的特异性诊断指标，在小儿心脏病的鉴别诊断中有重要价值，且有推广到基层医院的实用价值。

Abstract:

Objective To explore the diagnostic value of specific antiheart autoantibodies in children with myocardiac disease. Methods The plasma autoantibody against myocardiac adenine nucleotide translocator (ANT) and anti-myosin in children with myocardiac diseases, 30 cases with viral myocarditis (VMC) and 14 cases with dilated cardiomyopathy (DCM), were detected by western blot and enzyme-linked immunosorben assay. Results The plasma levels of anti-ANT and anti-myosin in the VMC and DCM group were significantly higher than those in the healthy group (P<0.05). The diagnostic sensitivity and specifity of anti-ANT and anti-myosin for VMC and DCM were 72.73%, 100% and 54.55%, 96%.Conclusions The anti-ANT and anti-myosin can be taken as specific markers of diagnosis for VMC and DCM . They have important value for differential diagnosis in children with cardiomyopathy, and can be extended to primary hospitals.