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目的：探讨血清心脏肌钙蛋白Ｉ（ｃＴｎＩ） 在急性心肌梗塞（ ＡＭＩ） 中的临床价值。方法：５０ 例正常人、２０ 例单纯骨骼肌损伤病人、２６ 例慢性肾功能不全透析病人、９２ 例ＡＭＩ 病人［３９ 例直接经皮冠状动脉腔内成形术（ＰＴＣＡ） ，２６ 例溶栓，２７ 例未ＰＴＣＡ 未溶栓］ 。ＡＭＩ 病人系列采血测定ｃＴｎＩ 和激酸激酶及其同功酶ＭＢ（ ＣＫＭＢ） ，直接ＰＴＣＡ 和溶栓再通的ＡＭＩ病人于入院后１５ ～３０ 天用核素心肌显像测定心肌梗塞面积指数，超声心动图测定左心室射血分数（ＬＶＥＦ） 。结果：①ｃＴｎＩ诊断ＡＭＩ 敏感性、特异性和准确性均为１００ ％ ，特异性高于ｃＴｎＴ 和ＣＫＭＢ；ＡＭＩ 时，ｃＴｎＩ 升高时间和高峰时间与ＣＫＭＢ平行，持续时间明显延长；ｃＴｎＩ 的释放受血管再通的影响，以峰值时间≤均数±标准差为标准判定ＡＭＩ 溶栓再通，ｃＴｎＩ 与ＣＫＭＢ价值相当。②ｃＴｎＩ峰值与梗塞面积指数呈正相关，与ＬＶＥＦ 呈负相关，相关性好于ＣＫＭＢ 峰值。１６８ 小时累加∑ｃＴｎＩ 与梗塞面积指数相关性比ｃＴｎＩ 峰值明显提高。③再灌注治疗２ 小时后ｃＴｎＩ 上升速率，直接ＰＴＣＡ 组明显高于溶栓再通组，ＰＴＣＡ 组梗塞面积指数?
Objective: To investigate the clinical value of serum cardiac troponin I (cTnI) in acute myocardial infarction (AMI). Methods: Fifty normal subjects, 20 patients with simple skeletal muscle injury, 26 patients with chronic renal failure, 92 AMI patients (39 patients undergoing direct percutaneous transluminal coronary angioplasty (PTCA), 26 patients with thrombolysis, 27 Cases did not PTCA thrombolysis]. AMI patients blood collection determination of cTnI and acid kinase and its isoenzyme MB (CK MB), direct PTCA and recanalization of thrombolytic patients with myocardial infarction 15 ~ 30 days after admission by myocardial imaging myocardial infarction area index , Echocardiography left ventricular ejection fraction (LVEF). Results ① The sensitivity, specificity and accuracy of cTnI in diagnosis of AMI were 100%, the specificity was higher than that of cTnT and CKMB. When AMI was used, the rising time and peak time of cTnI were parallel to CKMB, and the duration of cTnI was prolonged obviously Of the release by the recanalization of the impact of peak time ≤ mean ± standard deviation as the standard to determine AMI thrombol recanalization, cTnI and CK MB worth. ② cTnI peak and infarct size index was positively correlated with LVEF was negatively correlated, the correlation is better than CK MB peak. 168-hour cumulative ΣcTnI and infarct size index was significantly higher than cTnI peak. ③ After 2 hours of reperfusion, the rising rate of cTnI in PTCA group was significantly higher than that in thrombolytic group and PTCA group.