心脏彩超与血清心肌损伤标志物联合检测对急性心肌梗死诊断的临床意义  

Clinical significance of color doppler flow imaging and serum myocardial injury markers in the diagnosis of acute myocardial infarction

作　　者：刘竞芳[1] LIU Jing - fang(Department of Function, the First Hospital of Baoding, Baoding, Hebei 071000, China)

机构地区：[1]保定市第一医院功能科,河北保定071000

出　　处：《中国卫生检验杂志》2016年第23期3410-3412,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨心脏彩超联合心肌损伤标志物检测在急性心肌梗死患者中的临床运用价值。方法选择2014年8月-2016年5月在本院拟诊急性心肌梗死80例患者作为研究对象,并以同期40例胸痛疑似急性心肌梗死的患者为对照组,均采用超声心动图检查和血清心型脂肪酸结合蛋白(h-FABP)和心肌肌钙蛋白I(c Tn I)检测。结果急性心肌梗死组患者0 h^2 h h-FABP明显升高,而c Tn I处于正常高值,2 h^12 h和12 h^24 h的c Tn I和h-FABP水平均明显高于对照组各时间段,差异有统计学意义(P<0.05);h-FABP、c Tn I、心脏彩超对心肌梗死的诊断符合率分别为90.0%、85.0%、87.5%,联合诊断符合率为100.0%;以0 h^2 h心肌损伤指标水平及心脏彩超结果为标准,对心肌梗死进行诊断h-FABP+c Tn I+心脏彩超诊断的敏感性、特异性、阳性预测值、阴性预测值分别为87.6%、98.4%、87.5%和100.0%,高于单用h-FABP和c Tn I及心脏彩超进行诊断的患者。结论 h-FABP、c Tn I联合心脏彩超诊断心肌梗死,有助于减少急性心肌梗死的漏诊。Objective To investigate the clinical application value of color doppler echocardiography and myocardial injury markers in the diagnosis of acute myocardial infarction. Methods 80 patients with acute myocardial infarction（ AMI） from August 2014 to May 2016 in our hospital were selected as the research objects. 40 patients with suspected acute myocardial infarction in the same period were compared with the control group. All patients underwent ultrasound heartbeat graph examination of ultrasound echocardiography and h-FABP and c Tn I detection. Results h-FABP within 0 h-2 h significantly increased in patients with acute myocardial infarction group,while c Tn I was in normal high value; levels of c Tn I and h-FABP within 2 h-12 h and 12 h-24 h were significantly higher than those in control group,with the differences statistically significant（ P 〈0. 05）. The coincidence rate in the diagnosis of acute myocardial infarction patients with h-FABP,c Tn I and cardiac color Doppler sonography was 90. 0%,85. 0%,87. 5%,and the combined diagnosis effect coincidence rate was 100. 0%. With indicators of myocardial injury and cardiac ultrasound results in 0 h-2 h for standard,the diagnostic sensitivity,specificity,positive predictive value and negative predictive value of h-FABP ＋ c Tn I ＋ heart color Doppler ultrasound were 87. 6%,98. 4%,87. 5%,100. 0%,which were higher than that of single use of h-FABP and c Tn I or cardiac color Doppler ultrasound for the diagnosis of patients with myocardial infarction. Conclusion h-FABP,c Tn I combining heart color Doppler ultrasound in the diagnosis of myocardial infarction can help to reduce the missed diagnosis of acute myocardial infarction.

关 键 词：血清心型脂肪酸结合蛋白 心肌肌钙蛋白I 急性心肌梗死 超声心动图 

分 类 号：R542.22[医药卫生—心血管疾病]