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目的:探讨血清心肌酶谱和肌钙蛋白I(cTnI)联合检测在急性心肌梗死诊断中的应用价值。方法:选取2010年5月-2011年3月我院收治的急性心肌梗死患者54例,随机选取同期进行体检的健康人54例,作为对照组。使用酶法测定心肌酶谱,酶免疫法测定肌钙蛋白I水平。结果:AMI组血清心肌酶谱(ASK、α-HBD、LDH、CK-MB、CK)和cTnI检测结果均高于对照组,对比差异有统计学意义,P<0.05。心肌酶谱检测敏感性为87.0%,特异性为92.6%,两组心肌酶谱值的变化不同,P<0.05。肌钙蛋白I检测敏感性为92.6,特异性为94.4%,两组肌钙蛋白I改变不同,P<0.05。心肌酶谱检测4例假阳性,2例为急性胰腺炎、2例为胆结石;肌钙蛋白I检测3例假阳性,1例为急性胰腺炎,1例为肺血管栓塞,1例结核性胸膜炎。AMI患者中均未出现肌钙蛋白I和心肌酶谱检测均为阴性的病例。结论:血清心肌酶谱和肌钙蛋白I联合检测急性心肌梗死,协同互补,减少误诊漏诊,值得推广。
Objective: To investigate the value of combined detection of serum myocardial enzymes and cTnI in the diagnosis of acute myocardial infarction. Methods: 54 cases of acute myocardial infarction admitted to our hospital from May 2010 to March 2011 were randomly selected, and 54 healthy subjects were selected randomly during the same period as the control group. Enzymatic determination of myocardial enzymes, enzyme immunoassay of troponin I levels. Results: The levels of serum myocardial enzymes (ASK, α-HBD, LDH, CK-MB and CK) and cTnI in AMI group were significantly higher than those in control group. The difference was statistically significant (P <0.05). Myocardial enzymogram detection sensitivity was 87.0%, specificity was 92.6%, two groups of myocardial enzyme value changes, P <0.05. Troponin I detection sensitivity was 92.6, specificity was 94.4%, two groups of troponin I changed with different, P <0.05. There were 4 false positives in myocardial enzymes, 2 in acute pancreatitis and 2 in gallstones. There were 3 false positives in troponin I test, 1 in acute pancreatitis, 1 in pulmonary embolism and 1 in tuberculous pleurisy. No cases of troponin I and myocardial enzyme test were negative in AMI patients. Conclusion: Serum myocardial enzymes and cardiac troponin I combined detection of acute myocardial infarction, synergetic complementarity, reduce misdiagnosis and missed diagnosis, it is worth promoting.