关键词: 心型脂肪酸结合蛋白, 肌钙蛋白I, 肌红蛋白, 肌酸激酶同功酶MB, 手足口病, 心肌炎

Abstract: Objective To explore early clinical diagnostic value of serum heart type fatty acid binding protein （h-FABP）,troponin（cTnI）,myoglobin（Mb） and creatine kinase isoenzyme Mb （CK-Mb） detection in children's hand,foot and mouth disease （HFMD） combined with myocardial damage,for clinical provides the basis for early diagnosis of myocardial damage. Method sfor March to December 2015 in our hospital of pediatrics door and inhospital see a doctor and a diagnosis of 276 cases of children with hand,foot and mouth disease,eventually diagnosed with myocarditis 57 cases,at the same time,choose the same 40 healthy children as control group. Collection and different time after admission in patients with venous blood were determined in serum in children with h-FABP,cTnI,Mb and CK-Mb content,the differences of the index level compared with the control group,and analysis the dynamic change of its content in different time. Results 276 cases diagnosed with myocarditis in children with HFMD,57 cases of myocarditis concurrent rate was 20.65% （57/276）,detection within 0~3 h,276 cases of children with HFMD h-FABP in serum cTnI,Mb and CK-Mb abnormal rate was 20.29% （56/276）,1.81% （6/276）,14.86% （41/276） and 2.90% （8/276）,and abnormal rate of h-FABP and Mb was obviously higher than that of cTnI and CK-Mb,the difference was statistically significant between the Results （χ²= 35.132~37.063,P<0.01）,h-FABP abnormal rate is higher than that of CK-Mb,difference was statistically significant （χ²= 3.175,P<0.05）; HFDM combined serum h-FABP children suspicious viral myocarditis,cTnI,Mb and CK-Mb concentrations were significantly higher than that of control group,difference between index concentration were statistically significant （t=17.261~37.625,P<0.01）; After the occurrence of HFMD combined myocarditis 0~3h h-FABP and Mb concentration started to rise,4~9h peak,began to decline after 12,20~36h basic dropped to normal; CTnI and CK-MB concentration in HFDM combined myocarditis began to rise after 4~9h,10~12h peak,12~72h has been in a higher level,began to decline after 72h,7d basic drop to normal. Conclusion Children with HFMD myocarditis had a higher incidence of a disease,h-FABP is the most sensitive indicators for early diagnosis,can be used as ideal markers for early diagnosis of children with HFMD myocarditis followed by Mb;CTnI and CK-MB is children with HFMD myocarditis middle-late diagnostic sensitivity index. h-FABP joint detection cTnI,Mb and CK-Mb has important clinical value in early diagnosis ofchildren with HFMD myocarditis ,improvement of the diagnostic rate and lessening of the misdiagnosis rate,et al.

Key words: Heart type fatty acid binding protein, Troponin I, Myoglobin, Creatine kinase isoenzyme MB Hand foot and mouth disease, Myocarditis