急性心肌梗死早期患者3种血清测定及意义  

Determination of three serum indicators in patients with early AMI and its significance

作　　者：黄爱群[1] 严跃红[2] 钟玉婷[1] 

机构地区：[1]广州医学院港湾医院检验科,510700 [2]广州医学院港湾医院内科,510700

出　　处：《检验医学与临床》2011年第12期1461-1462,共2页Laboratory Medicine and Clinic

摘　　要：目的探讨血清肌酸激酶同工酶-MB(CK-MB)、肌红蛋白(Myo)和人心肌肌钙蛋白I(CTnI)检测在急性心肌梗死(AMI)早期诊断中的意义。方法以40例健康体检者作对照,检测85例高度疑为AMI的患者在发病6 h内检测3个血清指标水平。比较其对AMI诊断的性能,以进行优化组合检测。结果 AMI患者在发病6 h内,CK-MB、Myo和CTnI的敏感性分别为82.35%、100.00%和92.64%;特异性分别为94.74%、89.47%和100.00%;单项比较:敏感度和阴性预期值以Myo最高,特异度、阳性预期值和可靠性则以CTnI最佳;并联组合比较:敏感度、特异度、阳性预期值和阴性预期值均以CTnI与Myo最理想;可靠性则以CTnI与CK-MB联合最好;串联组合比较:5项指标均以CTnI与Myo串联检测为最佳。结论血清CTnI在AMI早期诊断中具有良好的灵敏度、特异性和可靠性。CTnI和Myo联合检测可提高对AMI早期诊断的性能。Objective To investigate the significance of serum creatine kinase isoenzyme-MB（CK-MB）,myoglobin（Myo）and cardiac troponin I（CTnI）in the early diagnosis of acute myocardial infarction（AMI）.Methods 40 healthy persons were as control group,and the serum levels of CK-MB,Myo and cTnI in 85 cases of highly suspicious patients with AMI in 6 hours after clinical symptoms were tested,then we compared the performance of diagnosis of AMI in order to optimize the combination of detection.Results The sensitivities of cTnI,CK-MB and Myo were 82.35%,100.00% and 92.64% in patients with AMI after 6 hours of onset,and the specificities were 94.74%,89.47%and 100.00%,respectively.For comparison of single item,the sensitivity and the negative predictive value of the Myo were the best among the three,and the specificity,the positive predictive value and the reliability of the CTnI were the best;Comparison of the parallel combination,the sensitivity,the specificity,the positive predictive value and the negative predictive value of the combined detection of CTnI and Myo were the best among the four,and the reliability of the combined detection of CTnI and CK-MB was the best;Comparison of series combination： the five indicators of the CTnI and Myo series detection were the best among the four.Conclusion The CTnI has good sensitivity,specificity and reliability in the early diagnosis of AMI.And the combined detection of CTnI and Myo can improve the performance of early diagnosis of AMI.

关 键 词：急性心肌梗死 肌酸激酶同功酶 肌红蛋白 人心肌肌钙蛋白I 

分 类 号：R542.22[医药卫生—心血管疾病]