急性心肌梗死时心脏标志物的合理选择和临床应用  

Rational choice and clinical application of cardiac markers in acute myocardial infarction patients

作　　者：林伟华[1] 陈华英[1] 梁金明[1] 朱彩兰[1] 

机构地区：[1]湛江中心人民医院,广东湛江524037

出　　处：《中国热带医学》2010年第4期460-461,共2页China Tropical Medicine

基　　金：湛江市科技计划项目(No:2006C08005)

摘　　要：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 rational choice and clinical application of cardiac markers in diagnosis of acute myocardial infarction at early stages. Methods The levels of cardiac markers of cTnI,Myo,CK-MB in veinous blood of 107 acute myocardial infarction patients 2,4 and 6 hours after onset were quantitatively determined by using the chemiluminescence. Meanwhile the cardiac markers in 30 normal control were also determined. Results The level of Myo increased 2 hours after onset with a sensitivity of 60.78% and specificity of 58.06%; The sensitivity of Myo,cTnI and CK-MB,4 hours after attack ,was 88.23%,45.10% and 52.94%,the specificity was 71.11%,81.48% and 82.61%,the sensitivity. 6 hour after attack,was all 100%,but the specificity was 88.24%,96.08% and 90.19% ,respectively. Conclusion Singular and joint determination of levels of eTnI, Myo and CK-MB can improve the sensitivity and the specificity in daignosis of acute myuoeardial infarction.

关 键 词：急性心肌梗死 肌钙蛋白I 肌红蛋白 肌酸激酶同工酶 

分 类 号：R542.22[医药卫生—心血管疾病]