Elevated cardiac troponin I level in cases of thoracic nonaccidental trauma.
Elevated cardiac troponin I level in cases of thoracic nonaccidental trauma.
复制标题
胸部非意外创伤时心肌肌钙蛋白 I 水平升高。
DOI：
10.1097/pec.0b013e3182307afe
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发表时间：
2011
影响因子：
1.4
通讯作者：
Hirsch,Russel
中科院分区：
文献类型：
--
作者：
Bennett,BerkeleyL;Mahabee-Gittens,Melinda;Chua,MichaelS;Hirsch,Russel
背景：非意外创伤 (NAT) 的损伤模式通常包括胸部损伤。然而，心脏损伤的体征和症状通常是非特异性的，可能会被忽视。心肌损伤特异性指标血清心肌肌钙蛋白I（CTnI）的评估，可以提高对疑似NAT患者的综合评估。 目的：本研究的目的是描述胸部NAT患儿的患者特征和CTnI检测结果。方法：将那些获得CTnI且至少有以下一种情况的儿童纳入急诊科：胸部钝性外伤史、胸部瘀伤或擦伤史，或肋骨、胸骨或锁骨骨折。血清 CTnI 水平高于 0.04 ng/mL 被认为升高。 结果：在 17 个月的研究期间，确定了 10 名患者（6 名男性），年龄范围为 2 个月至 4 岁（平均 [SD]，20 [20] 个月）。所有患者均接受 NAT 评估。 10 名患者中有 7 名 (70%) 心肌肌钙蛋白 I 水平升高，其水平在正常上限的 2 至 50 倍之间。结论：本报告首次记录了胸部 NAT 病例中 CTnI 水平升高的情况。这种特定生物标志物水平的升高可能表明胸部创伤足以导致心脏受伤，而与是否存在心脏代偿失调或其他原因引起的休克无关。有必要对该人群中 CTnI 的法医和临床应用进行前瞻性评估。
Background:Injury patterns in nonaccidental trauma (NAT) often include injury to the chest. However, signs and symptoms of cardiac insult are often nonspecific and may be missed. Evaluation with serum cardiac troponin I (CTnI), a specific indicator of myocardial injury, could improve the comprehensive evaluation of patients with suspected NAT.Objective:The objective of this study was to describe the patient characteristics and results of CTnI testing in children with thoracic NAT.Methods:Children presenting to the emergency department were included if CTnI was obtained and they had at least one of the following: history of blunt trauma to the chest, bruising or abrasions to the chest, or fractures of the ribs, sternum, or clavicles. A serum CTnI level above 0.04 ng/mL was considered elevated.Results:Ten patients (6 males) with an age range from 2 months to 4 years (mean [SD], 20 [20] months) were identified during the 17-month study period. All patients were evaluated with NAT. Cardiac troponin I level was elevated in 7 (70%) of 10 patients with levels between 2 and 50 times the upper limit of normal.Conclusions:This report is the first to document elevation of CTnI levels in cases of thoracic NAT. The elevation of the level of this specific biomarker may be indicative of sufficient chest trauma to result in the heart being injured, independent of the presence of cardiac decompensation or shock from other causes. Prospective evaluation of the forensic and clinical use of CTnI in this population is warranted.