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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T(cTnT)、肌钙蛋白I(cTnI)的变化 ,探讨cTnT、cTnI对早期诊断AMI的价值。方法 :对 10 0例患者 (AMI 5 0例、不稳定型心绞痛 5 0例 )和 2 0例健康人进行了血清cTnT、cTnI、肌酸激酶 (CK)和肌酸激酶同工酶 (CK MB)检测。结果 :①血清cTnT、cTnI、CK和CK MB检测AMI的敏感度和特异度分别为 80 %和 90 %、85 %和 92 %、92 %和 6 1%、75 %和 75 %。②AMI患者血清cTnT、cTnI浓度平均升高 (17.5± 5 .7)和 (16 .2± 4 .8)倍 ,显著高于CK(7.6± 3.1)倍、CK MB (6 .5± 2 .9)倍 (P <0 .0 1) ;③AMI后 3h内cTnT、cTnI阳性检出率为 5 0 .0 %、4 0 .0 % ,明显高于CK MB(2 4 .0 % )和CK(2 0 .0 % ) ;AMI 5d后cTnT、cTnI阳性检出率为 70 .0 %、6 6 .0 % ,而CK MB和CK仅为 4 .0 %和 8.0 %。结论 :血清cTnT、cTnI能早期确切诊断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 cardiac troponin T (cTnT) and troponin I (cTnI) in patients with acute myocardial infarction (AMI) before admission and investigate the value of cTnT and cTnI in the early diagnosis of AMI. Methods: Serum cTnT, cTnI, creatine kinase (CK) and creatine kinase MB (CK) were detected in 100 patients (50 cases of AMI, 50 cases of unstable angina pectoris) and 20 healthy people. ) Test. Results: ① The sensitivity and specificity of serum cTnT, cTnI, CK and CK MB in detecting AMI were 80% and 90%, 85% and 92%, 92% and 61%, 75% and 75% respectively. (2) The serum levels of cTnT and cTnI in AMI patients were significantly higher than those in CK (7.6 ± 3.1) and CK (6.5 ± 2.9) ) (P <0.01); ③The positive detection rate of cTnT and cTnI within 3h after AMI was 50.0% and 40.0%, which was significantly higher than CK MB (24.0%) and CK 20.0% and 60.0% respectively). The positive rates of cTnT and cTnI after AMI were 70.0% and 6.6% respectively, while CK MB and CK were only 4.0% and 8.0% respectively. Conclusions: Serum cTnT and cTnI can diagnose AMI accurately in the early stage and have a wide time diagnosis window, which is a sensitive and specific serum marker for early diagnosis of myocardial infarction