超敏cTnT、超敏cTnI、CK-MB质量和CK-MB活性诊断AMI的灵敏度、特异度以及准确度分析  

Sensitivity, specificity and accuracy of high-sensitive cTnT, high-sensitive cTnI, CK-MB mass and activity for acute myocardial infarction

作　　者：张成[1] 韩光[1] 彭桉平[1] 何敏[1] 陈炜烨[1] 万泽民[1] 吴晓宾[1] 王云秀[1] 王建兵[1] 

机构地区：[1]广东省中医院检验科,广州510120

出　　处：《国际医药卫生导报》2015年第16期2307-2310,共4页International Medicine and Health Guidance News

基　　金：国家自然科学基金青年基金（81303287）

摘　　要：目的 评价超敏肌钙蛋白T（cTnT）、超敏肌钙蛋白I（cTnI）以及肌酸激酶同工酶质量（CK-MBmass）和肌酸激酶同工酶活性（CK-MB活性）检测在诊断急性心肌梗死（AMI）中的灵敏度、特异度以及准确度,为临床选择适当的诊断AMI指标提供依据.方法 按不同的采血时间点,采用电化学发光法、化学发光法以及透射比浊法测定AMI组、稳定型心绞痛（SAP）组与健康对照组的血清超敏cTn和CK-MB水平,并对结果进行统计学分析,计算各指标的灵敏度、特异度以及准确度.结果 在0、3、6h不同的采血时间点,超敏cTnT诊断AMI的敏感度分别是62.89％、95.88％、100％,特异度分别是98.76％、98.76％、98.76％,准确度分别是79.21％、97.19％、99.44％;超敏cTnI诊断AMI的敏感度分别是72.16％、96.91％、98.76％,特异度分别是98.76％、97.53％、97.53％,准确度分别是84.27％、97.19％、98.31％;CK-MB质量诊断AMI的敏感度分别是27.00％、63.92％、92.78％,特异度分别是92.59％、90.12％、88.89％,准确度分别是55.62％、75.84％、91.01％;CK-MB活性诊断AMI的敏感度分别是28.86％、71.13％、93.81％,特异度分别是87.65％、83.95％、81.48％,准确度分别是55.62％、76.97％、88.20％.结论 超敏cTn诊断AMI的灵敏度、特异度和准确度明显高于CK-MB质量和CK-MB活性;超敏cTn应用于AMI的诊断和鉴别诊断,可以大大提高急性AMI的早期诊断率.Objective High-sensitive troponin T （cTnT）,high-sensitive troponin I （cTnI）,creatine kinase isoenzyme （CK-MB） mass and activity were measured,analyzed the sensitivity,specificity and accuracy of these indicators in the diagnosis of acute myocardial infarction （AMI）,which provided proper diagnosis marker of AMI.Methods The levels of serum high sensitive cTnT,cTnI and CK-MB from AMI group,stable angina pectoris （SAP） group and healthy control group were detected by electrochemical luminescence method,chemiluminescence method and turbidimetry respectively at different blood sampling time points.Then the results were statistically analyzed,and the sensitivity,specificity and accuracy were calculated.Results At different blood sampling time points （0 h,3 h and 6 h）,the sensitivity of high-sensitive cTnT in the diagnosis of AMI was 62.89％,95.88％,100％ respectively,the specificity was 98.76％,98.76％,98.76％ respectively,and the accuracy was 79.2 1％,97.19％,99.44％ respectively;the sensitivity of high-sensitive cTnI in the diagnosis of AMI was 72.16％,96.91％,98.76％ respectively,the specificity was 98.76％,97.53％,97.53％ respectively,and the accuracy was 84.27％,97.19％,98.31％ respectively;the sensitivity of CK-MB mass in the diagnosis of AMI was 27.00％,63.92％,92.78％ respectively,the specificity was 92.59％,90.12％,88.89％ respectively,and the accuracy was 55.62％,75.84％,91.01％ respectively;the sensitivity of CK-MB activity in the diagnosis of AMI was 28.86％,71.13％,93.81％ respectively,the specificity was 87.65％,83.95％,81.48％ respectively,and the accuracy was 55.62％,76.97％,55.62％ respectively.Conclusion The sensitivity,specificity and accuracy of high-sensitive cTn in the diagnosis of AMI were significantly higher than those of CK-MB mass and CK-MB activity.Hypersensitivity cTn is applied to the diagnosis and differential diagnosis of AMI,and can greatly improve early diagnosis of AMI.

关 键 词：肌酸激酶同工酶 超敏肌钙蛋白 质量 活性 急性心肌梗死 

分 类 号：R542.220.4[医药卫生—心血管疾病]