心肌肌钙蛋白T、肌钙蛋白I及CK-MB诊断急性心肌梗死临床应用价值的比较分析  

Comparison of the Application value of Cardiac troponin I(cTnI),cardiac troponin T(cTnT),and creatine kinase MB(CK-MB) for the diagnosis of acute myocardial infarction(AMI)

作　　者：冯品宁[1] 刘敏[1] 崔颖鹏[1] 叶曼曼[1] 张式鸿[1] 姜傥[1] 

机构地区：[1]中山大学附属第一医院检验医学部,广东广州510080

出　　处：《中国实验诊断学》2008年第10期1256-1258,共3页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨新一代心肌肌钙蛋白T(cTnT)、肌钙蛋白I(cTnI)及肌酸激酶同工酶MB(CK-MB)早期诊断急性心肌梗死的临床应用价值,为临床合理、科学选用心肌损伤标志物提供参考。方法分别使用Elecsys2010电化学发光免疫分析系统、Abbott AxSym全自动免疫分析系统及日立HITACHI7170A全自动生化分析仪同时对23例急性心肌梗塞(AMI)患者、18例不稳定性心绞痛(UA)患者及23例非AMI患者的血清心肌钙蛋白I、肌钙蛋白T及CK-MB进行检测,分别进行组间比较,并对AMI组和UA组各指标作对比分析。结果cTnT、cTnI诊断急性心肌梗死灵敏度一致(P>0.05),而均高于CK-MB(P<0.01),三者阳性率分别为82.6%、95.7%、43.5%,UA组中上述3指标阳性率分别为22.2%、38.9%和11.1%,明显低于AMI组(P<0.01)。结论心肌肌钙蛋白I和肌钙蛋白T在AMI的早期诊断中具有较高灵敏度和较强特异性,可较好地用于AMI与UA的早期诊断与鉴别,两者临床使用价值基本一致,而均优于传统心肌酶CKMB;但在AMI早期,cTnI水平变化幅度比cTnT大,显示出较高的敏感性。Objective To observe the application value of cardiactroponird（cTnI）, cardiac troponin T（cTnT） and ereatine kinase MB （CK-MB） for the early diagnosis of acute myocardial infarction （AMI） .Methods to detennin the plasma level of cTnI,eTnT and CK-MB in patients（23 with acute myocardial infarction, 18 patients with unstable angina and 23 patients with other diseases）. Comparison between AMI and UA was performed and all the indexes were analysed contrastively.Results The sensitivity of eTnI and cTnT in diagnosing AMI are higher than that of CK-MB, and their positive rates were 82.6%, 95.7 % and 43.5 % respectively, while in UA, their rates are 22.2%, 38.9%, and 11.1%, obviously lower than that of AMI. Conclusion eTnI and eTnT, as specific markem of cardiac damage, are more sensitive and specific in the early diagnosis of AMI, more reliable than CK-MB. While in the early period of AMI, detecting cTnI is a more convenient, swift and accurate measurement method, and has significant clinical value.

关 键 词：急性心肌梗死 心肌肌钙蛋白I 心肌肌钙蛋白T 肌酸激酶同工酶MB 

分 类 号：R542.22[医药卫生—心血管疾病]