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目的探讨心脏标志物血清心肌肌钙蛋白(IcTnI),肌红蛋白(Myo),肌酸激酶同工酶(CK-MB)单项及联合检测的合理选择在诊断急性心肌梗死(AMI)早期中的临床应用。方法采用化学发光法在1h内对检测标本定量测定cTnI、Myo、CK-MB;分别采集107例患者发病后2、4、6h静脉血,同时检测30例正常对照。结果在发病后2h,只有Myo的含量升高,敏感性达到60.78%,特异性58.06%;发病后4h,Myo、cTnI和CK-MB的敏感性分别为88.23%、45.10%和52.94%,特异性分别为71.11%、81.48%、82.61%;发病后6h,Myo、cTnI、CK-MB的敏感性均为100%,特异性分别为88.24%、96.08%、90.19%,含量显著高于对照组(P<0.01)。结论cTnI、Myo、CK-MB单项和多项联合检测的合理选择,可提高对诊断AMI的敏感性和特异性,连续采血检测更能提高诊断率和病情分析。
Objective To investigate the reasonable choice of single and combined detection of serum cardiac troponin (IcTnI), myoglobin (Myo) and creatine kinase (CK) MB in the early diagnosis of acute myocardial infarction (AMI) Clinical application. Methods Chemiluminescence was used to quantify cTnI, Myo and CK-MB in test specimens within 1 hour. Venous blood was collected at 2, 4 and 6 hours after the onset of disease in 107 patients, and 30 normal controls were also detected. Results The Myo, cTnI and CK-MB were only 88.23%, 45.10% and 52.94% sensitive to Myo at 2h after onset, respectively, with a sensitivity of 60.78% and a specificity of 58.06% The sensitivities of Myo, cTnI and CK-MB were 100% and 88.24%, 96.08% and 90.19% respectively, which were significantly higher than that of the control group at 71.11%, 81.48% and 82.61% respectively (P <0.01). Conclusion The reasonable selection of single and multiple combined detection of cTnI, Myo and CK-MB can improve the sensitivity and specificity of the diagnosis of AMI. Continuous blood sampling can improve the diagnosis rate and condition analysis.