儿童和年轻人的心脏热素值:一个多中心队列研究
Alexander J F Thurston1, Eirik Å Røys2,3, Ragnhild Røysland4,5
1BHF Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, United Kingdom.
The journal of applied laboratory medicine
|January 20, 2026
概括
对于高灵敏度心脏热素 (hs-cTn) 测定,使用儿科特异性值显著增加了儿童和年轻成年人心肌损伤的识别. 需要进一步的研究来了解这些发现的临床影响.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 生物标志物研究 生物标志物研究
- 诊断值是指诊断值的值.
背景情况:
- 在儿科人群中,高灵敏心脏热素 (hs-cTn) 检测的诊断实用性尚不清楚,缺乏确定的诊断值.
- 当前的临床实践往往依赖于成人参考值,这可能导致对儿童和年轻成年人hs-cTn结果的误解.
研究的目的:
- 评估应用小儿与成人上限参考值 (URL) 的hs-cTn测定在诊断小儿心肌损伤患者的影响.
- 为了比较不同儿科性别特异的hs-cTn.百分点值的诊断产量.
主要方法:
- 一项回顾性,多中心的国际队列研究,涉及9833名来自挪威和苏格兰的4家三级医院的儿童和年轻人 (1天至18岁).
- 心肌损伤的分类是使用成人性别特异的99百分点URL,儿科性别特异的99百分点URL和儿科性别特异的97.5百分点URL.
- 心肌炎的诊断通过挪威患者登记册和苏格兰发病率记录得到证实.
主要成果:
- 应用儿科性别特异的97.5百分位数URL发现,与成人值相比,心肌损伤分类的相对增加为28%.
- 婴儿在使用儿科97.5百分位数URL时,心肌损伤的频率 (93.8%) 与较大的儿童和年轻成年人 (14.0%) 相比显著更高.
- 在研究期间,心脏类素检测频率大幅增加 (τ = 0.42,P < 0.001).
结论:
- 对hs-cTn测定采用儿科特异性的第97.5百分位数URL将导致儿科患者心肌损伤的更高分类.
- 这种增加的检测率的临床意义和管理影响需要进一步调查.
- 在过去十年中hs-cTn测试的上升趋势强调了需要适合年龄的诊断指南.
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