肌钙蛋白I与肌酸激酶同工酶在老年人急性心肌梗死中的应用价值  

Aapplication value of cTnI and CK-MB in elderly patients with acute myocardial infarction

作　　者：刘艳 王辉 

机构地区：[1]上海市一钢医院检验科,200431 [2]上海执诚生物科技股份有限公司,201318

出　　处：《检验医学与临床》2015年第6期732-733,736,共3页Laboratory Medicine and Clinic

基　　金：上海市科学技术委员会科研项目(11DZ1931500)

摘　　要：目的研究肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)对老年急性心肌梗死(AMI)的诊断价值。方法选取2012年1月至2014年6月心内科临床确诊的106例老年AMI患者为AMI组,68例老年胸痛患者为胸痛组,另选取64例老年体检健康者为对照组。比较cTnI、CK-MB检测对AMI的诊断效果,并分析cTnI、CK-MB在AMI发生后不同时间段的变化情况。结果 AMI组患者血清cTnI与CK-MB水平及阳性率均高于胸痛组与对照组,差异均有统计学意义(P<0.05);cTnI对AMI的诊断灵敏度、特异度及约登指数分别为92.2%、94.7%、0.869,CK-MB的上述指标分别为87.4%、90.9%、0.783,两指标联合检测的灵敏度、特异度及约登指数均有所提高;AMI组患者cTnI与CK-MB水平均在入院后12h至1d达到最高,随后下降。结论 cTnI与CK-MB联合检测对AMI的早期诊断与防治有重要的临床意义,适宜在基层医院推广应用。Objective To study the diagnostic value of cardiac troponin I（cTnI）,creatine kinase isoenzyme MB（CK-MB）in elderly acute myocardial infarction（AMI）.Methods 106 elderly patients with AMI from Jan.2012 to Jun.2014 were selected as the AMI group,68 elderly patients with chest pain as the chest pain group and 64 elderly individuals of healthy physical examination as the healthy control group.The effect of cTnI and CK-MB detection on the diagnosis of AMI,and the changes of cTnI and CK-MB in different periods after AMI occurrence were researched.Results The levels and positive rates of serum cTnI and CK-MB were higher than those in the chest pain group and the healthy control group,the differences were statistically significant（P〈0.05）;the sensitivity,specificity and Jorden index of cTnI for the diagnosis of AMI were 92.2%,94.7% and 0.869 respectively,which of CK-MB were 87.4%,90.9% and 0.783 respectively,the sensitivity,specificity and Jorden index of the combined detection of these two indexes were increased to some extent;the levels of cTnI and CK-MB during 12 hto 1dafter admission were highest and then decreased.Conclusion The combination detection of cTnI and CK-MB could have important significance to the early diagnosis and treatment of AMI,which may be suitable for the promotion and application in the primary level hospitals.

关 键 词：急性心肌梗死 肌钙蛋白I 肌酸激酶同工酶 胸痛 

分 类 号：R542.22[医药卫生—心血管疾病]