心肌钙蛋白T和氨基末端脑钠肽前体联合检测对急性心肌梗死早期诊断的临床价值  

作　　者：陈瑞芳[1] 曾育辉[1] 梁秋玲[1] 

机构地区：[1]广东药学院附属第一医院急诊科,广东510080

出　　处：《当代医学》2013年第15期9-12,共4页Contemporary Medicine

摘　　要：目的探讨早期床旁快速全血心肌钙蛋白T(cTnT)和氨基末端脑钠肽前体(NT-proBNP)联合检测对急性心肌梗死(AMI)早期诊断的临床价值。方法选取2010年1月-2012年8月广东药学院附属第一医院急诊科收治的高度可疑AMI、发病时间在6h内的138例急诊患者,按AMI诊断标准分为急性心肌梗死组(AMI组)和非急性心肌梗死组(非AMI组);在就诊即刻床边抽取肘静脉全血检测cTnT的浓度和NT-proBNP的浓度,并对结果进行比较分析。其中临床确诊为急性心肌梗死(AMI组)72例,设为实验组;非急性心肌梗死(非AMI组)66例,设为对照组。结果 AMI组患者全血cTnT和NT-proBNP含量均明显高于非AMI组(P<0.05);联合检测cTnT和NT-proBNP对AMI早期诊断的敏感度为90.2%,特异性为90.9%,与分别单独检测cTnT和NT-proBNP的敏感度和特异性(分别为80.6%、77.8%和84.8%、83.3%)比较明显增高(P<0.05)。结论早期床旁快速联合检测全血cTnT与NT-proBNP水平,可明显提高AMI早期诊断的敏感度和特异性,有助于AMI的早期诊断,特别适用于急诊室及院前急救。Objective To explore the clinical value of cardiac troponin T （cTnT） and N terminal pro-brain natriuretic peptide （NT-proBNP） detected together rapidly bedside at the early stage for early diagnosis of acute myocardial infarction（AMI）. Methods 138 emergency cases highly suspected acute myocardial infarction at the onset of symptoms within 6 hours were seleted and divided into AMI group and non-AMI group by the diagnostic criteria of AMI at our Emergence Department from January 2010 to August 2012.Their cTnT and NT-proBNP level fi＇om elbow venous whole blood were detected immediately bedside and compared statistically. Of the 138 cases, 72 were diagnosed as acute myocardial infarction （AMI group, experimental group） and 66 as non-AMI （non-AMI group, control group）. Results The cTnT and NT-proBNP level in AMI group were significant higher than non-AMI group （P〈0.05）. The sensitivity and specificity of diagnosis of acute myocardial infarction with cTnT and NT-proBNP detected together were 90.2% and 90.9% respectively, which was obviously higher than their sensitivity and specificity detected lonely （cTnT and NT- proBNP were 80.6%, 77.8%; 84.8%, 83.3% respectively）, P〈0.05. Conclusion The level of cTnT and NT-proBNP detected together rapidly bedside at the early stage can improve the sensitivity and specificity efficiency and is helpful for the early diagnosis of acute myocardial infarction, especially in Emergence Room and pre-hospital care.

关 键 词：急性心肌梗死 心肌钙蛋白T 氨基末端脑钠肽前体 联合检测 敏感性 特异性 早期诊断 

分 类 号：R542.22[医药卫生—心血管疾病]