CK-MB质量法与高敏肌钙蛋白T联合测定在急性心肌梗死中的临床价值比较  

The clinical evaluation of CK-MB quality standard with High-sensitivity cardiac troponin T assay in the diagnosis of acute myocardial infarction

作　　者：龚国忠[1] 蒲泽晏 刘友迎 涂建华[1] 刘益均[1] 刘方久[1] 杨瀚轩 

机构地区：[1]遂宁市中心医院检验科,四川遂宁62900

出　　处：《西部医学》2013年第8期1251-1253,共3页Medical Journal of West China

基　　金：四川省卫生厅资助课题(100578)

摘　　要：目的探讨联合质量法测定CK-MB和高敏肌钙蛋白测定在急性心肌梗死(AMI)中的临床价值。方法收集我院2010～2012年临床确诊的新发病例62例对其进行研究,对照组70例。在发病4～10、18～26、40～52h时同时测定CK-MB、hs-cTNT含量,比较两者在AMI患者中不同时间段的敏感性和特异性,确定联合质量法测定CK-MB和高敏肌钙蛋白的临床价值。结果 CK-MB、hs-cTNT两者在发病4～10h时显著高于对照组,差异有显著性(P<0.05)。CK-MB敏感性与特异性分别为90.6%和80.9%,低于hs-cTNT的95.1%和97.2%(P<0.05);两者在18～26h时的敏感性和特异性分别为93.4%、92.1%和99.2%、100%,差异无显著性(P>0.05);在40～52h时hs-cTNT的敏感性和特异性为98.5%、100%,均高于CK-MB质量法的84.4%、79.3%,差异有显著性(P<0.01)。而作ROC曲线分析时,CK-MB质量法的ROC曲线下面积在4～10h和40～52h时分别为0.83、0.77,均低于高敏肌钙蛋白T的0.93、0.97(P<0.05);而在18～26h时两者比较差异无显著性(P>0.05)。结论在AMI患者中,质量法测定CK-MB早期效果稍差,而hs-cTNT检测能够为AMI的早期诊断提供更为可靠的依据,但因两者在病情变化过程中其水平随时间的不同而不同,因此联合测定两者对诊断和病情更有价值。Objective To explore clinical value of CK-MB quality standard with High-sensitivity cardiac troponin T assay in the diagnosis of acute myocardial infarction. Methods 62 cases of newly diagnosed AMI were collected from 2010-2012 to study with 70 cases of normal control. In, the content of CK-MB and hs-cTNT were determined at the time of 4-10 h, 18-26 h, 40-52h of the disease, the sensitivity and specificity in two different time periods were compared. The clinical value of the joint quality standard determination of CK-MB and hs-cTNT were determined. Results Both CK-MB and hs-cTNT in the 4-10h is significantly higher than those of the control group, with significant difference （P〈0. 05）. CK-MB in the sensitivity and specificity were 90. 6%, 80. 9%, below the hs-cTNT, 95.1%,97.2%（P〈0.05）. Be- tween 18-26h when the sensitivity and specificity of 93.4%, 92.1% respectively; 99. 2%, 100%, which shows no obvi- ous difference （P〉0. 05）. At 40-52h, hs-eTNT sensitivity and specificity of 98. 5%, 100%, were higher than CK-MB quality standard of 84. 4%, 79. 3%, compared with significant difference （P〈0.01）. ROC curve analysis, CK-MB qual- ity standard of the area under the ROC curve in 4-10h and 40-52h, respectively, 0. 83 and 0. 77 below hs-cTNT, 0.93, 0.97 （P〈0. 05）. In 18-26h, there is no obvious difference （P〉0.05）. Conclusion In early acute myocardial infarction, the effect is a bit poor quality standard determination of CK-MB, and hs-cTNT detection is able to provide more reliable diagnostic basis for early diagnosis of AMI, but both in the process of condition change its level varies with time, so the joint determination of both diagnosis and a more valuable.

关 键 词：急性心肌梗死 高敏肌钙蛋白T CK-MB质量法 

分 类 号：R542.22[医药卫生—心血管疾病]