脑钠肽、肌红蛋白及肌钙蛋白Ⅰ联合测定对早期诊断急性心肌梗死的临床意义  

Clinical value of joint detection of BNP,MYO and cTnⅠ in early diagnosis of acute myocardiail infarction

作　　者：沈振芳[1] 沈昊[1] 沈国荣[1] 

机构地区：[1]江苏省吴江市第一人民医院检验科,江苏吴江215200

出　　处：《临床军医杂志》2012年第1期94-96,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨急性心肌梗死(AMI)患者血浆脑钠肽(BNP),血清肌红蛋白(MYO),肌钙蛋白I(cTnI)的浓度变化及三者间的相关性,以探讨其对AMI的临床意义。方法采用化学免疫荧光法定量检测47例AMI患者入院后24 h内的BNP,MYO和cTnⅠ,并进行比较分析单个测定以及联合测定时诊断AMI的敏感性和特异性。结果 (1)AMI组BNP,MYO及cTnI的结果与健康对照组相比较,均有显著升高(P<0.05)。(2)在胸痛发作后2～6 h BNP,MYO,cTnI以及三项联合检测敏感性分别为76.2%,62.1%,74.2%,93.5%和特异性分别为79.2%,63.5%,82.7%,77.9%;在胸痛发作后6～12 h BNP,MYO,cTnI以及三项联合检测敏感性分别为89.5%,67.8%,83.5%,95.9%和特异性分别为84.3%,62.1%,88.3%,80.6%;在胸痛发作后12～24 h BNP,MYO,cTnI以及三项联合检测敏感性分别为94.7%,85.9%,92.6%,98.5%和特异性分别为97.6%,59.4%,96.5%,83.1%。结论 BNP,MYO及CTnI联合检测可以提高AMI检测的敏感性,有助于AMI早期诊断。Objective To investigate the concentration changes and the correlation among plasma brain natriuretic peptide（BNP）,myoglobin（MYO）,and cardiac tropnin Ⅰ（cTnI）,and to analyze their clinical significance.Methods The concentrations of BNP,MYO and cTnI were determined by chemical immune fluorescence method in 47 patients with acute chest pain in our hospital within 24 hours.The respective sensitivity,specificity and their relativity were analyzed.Results（1）Compared with healthy control group,there was a significant increase in BNP,MYO and cTnI of AMI group（P〈0.05）.（2）The sensitivity of AMI diagnosis： 2～6h after onset of chest pain,BNP was 76.2%,MYO was 62.1%,cTnI was 74.2%,BNP,MYO and cTnI in combination was 93.5%,The specificity of AMI diagnosis： 2～6h after onset of chest pain,BNP was 79.2%,MYO was 63.5%,cTnⅠ was 82.7%,BNP,MYO and cTnI in combination was 77.9%;6～12h after onset of chest pain,their sensitivities were 89.5%,67.8%,83.5% and 95.9%,respectively,their specificities were 84.3%,62.1%,88.3% and 80.6%,respectively;12～24h after onset of chest pain,their sensitivities were 94.7%,85.9%,92.6% and 98.5%,respectively,their specificities were 97.6%,59.4%,96.5% and 83.1%,respectively.Conclusion The measurement of BNP,MYO and cTnI in combination can improve the sensitivity of AMI detection.It is helpful to the early diagnosis of AMI.

关 键 词：脑钠肽 肌红蛋白 肌钙蛋白 急性心肌梗死 

分 类 号：R542.22[医药卫生—心血管疾病]