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目的观察急性心肌梗死(AMI)患者入院前后血清肌钙蛋白I(cTnI)的变化,并探讨cTnI对早期诊断AMI的价值。方法对100例患者(AMI50例、不稳定型心绞痛50例)和50例健康人进行了血清cTnI、肌酸肌酶CK和肌酸肌酶同工酶CK-MB检测。结果(1)血清cTnI、CK、CK-MB检测对AMI的敏感度和特异度分别为88%和96%、90%和61%、76%和75%;(2)AMI患者血清cTnI浓度平均升高(16.5±5.7)倍,显著高于CK(7.63±2.1)倍、CK-MB(6.4±2.8)倍(P<0.01)(;3)AMI后3h内cTnI阳性检出率41.0%,明显高于CK-MB(24.0%)和CK(21.0%);AMI5d后cTnI阳性检出率为69.0%,而CK-MB和CK仅为4.0%和8.0%。结论血清cTnI能早期确诊AMI,具有较宽的时间诊断窗口,是心肌梗死早期诊断较敏感和特异的血清标志物。
Objective To observe the changes of serum troponin I (cTnI) in patients with acute myocardial infarction (AMI) before admission and investigate the value of cTnI in the early diagnosis of AMI. Methods Serum levels of cTnI, creatine kinase CK and creatine kinase CK-MB were measured in 100 patients (50 AMI, 50 unstable angina pectoris) and 50 healthy controls. Results (1) The sensitivity and specificity of serum cTnI, CK and CK-MB in AMI were 88% and 96%, 90% and 61%, 76% and 75% respectively. (2) (P <0.01); (3) The positive detection rate of cTnI within 3 hours after AMI was 41.0%, which was significantly higher than that of CK (7.63 ± 2.1) and CK-MB (24.0%) and CK (21.0%). The positive rate of cTnI after AMI was 69.0%, while CK-MB and CK were only 4.0% and 8.0% respectively. Conclusions Serum cTnI can be used to diagnose AMI early and has a wide time window. It is a sensitive and specific serum marker for early diagnosis of myocardial infarction.