联合检测超敏肌钙蛋白Ⅰ和心肌酶在急性冠脉综合征的临床意义  

The Clinical Significance of High Sensitive cTnⅠ And Myocardial Enzyme in Patients with Acute Coronary Syndrome

作　　者：高淑娟[1] 江文艳[2] GAO Shu-juan;JIANG Wen-yan(Department of Internal Medicine,Kaiping Hospital,Tangshan people＇s Hospital Group,Tangshan,063001,China;Department of Cardiology,people＇s Hospital of Tangshan City,Hebei Province,Tangshan,063001,China)

机构地区：[1]河北省唐山市人民医院集团开平医院内科,唐山063001 [2]河北省唐山市人民医院心内科,唐山063001

出　　处：《血栓与止血学》2018年第5期786-788,791,共4页Chinese Journal of Thrombosis and Hemostasis

摘　　要：目的探讨联合检测超敏肌钙蛋白I(hs-cTnI)和心肌酶在急性冠脉综合征(ACS)的临床意义。方法按照疾病类型将175例ACS患者分为不稳定型心绞痛(UAP)组61例、ST段抬高型心肌梗死(STEMI)组71例和非ST段抬高型心肌梗死(NSTEMI)组43例,另外选择40例健康志愿者作为对照组,比较四组入选者血清hs-cTnI、肌酸激酶同工酶(CK-MB)水平,并分析hs-cTnI、CK-MB诊断ACS敏感度、特异性。结果 UAP组、STEMI组、NSTEMI组患者hsc Tn I、CK-MB水平均显著高于对照组(P<0.05); UAP组患者hs-cTnI、CK-MB水平显著低于STEMI组(P<0.05);单支冠脉病变、双支冠脉病变、三支冠脉病变组患者hs-cTnI、CK-MB水平均显著高于对照组(P<0.05);单支冠脉病变组患者hs-cTnI、CK-MB水平<双支冠脉病变<三支冠脉病变组(P<0.05); hs-cTnI、CK-MB联合诊断ACS敏感度、特异性和准确度均显著高于单纯CK-MB,准确度显著高于单纯hs-cTnI(P<0.05)。结论联合检测hs-cTnI与CK-MB对诊断ACS和评估ACS类型及病变严重度有较高的临床意义。Objective To explore the clinical significance of high sensitive cTnI and myocardial enzyme in patients with acute coronary syndrome（ACS）.Methods 175 cases of patients with ACS were divided into unstable angina pectoris（UAP） group（61 cases）,ST elevation acute coronary syndrome（STEMI）group（71 cases） and no-ST elevation acute coronary syndrome（NSTEMI） group group（43 cases）.40 cases of healthy volunteers were bring into control group.The levels of hs-cTnI and CK-MB for the four groups and sensitiveness,distinctness of ACS diagnosed by hs-cTnI or CK-MB were observed.Results The level of hscTnI,CK-MB for UAP group,STEMI group and NSTEMI group were higher than control group（P〈0.05）;The level of hs-cTnI,CK-MB for UAP group were lower than STEMI group（P〈0.05）;The level of hs-cTnI,CK-MB for one,two and three coronary artery lesion group were higher than control group（P〈0.05）;The level of hs-cTnI,CK-MB for one coronary artery lesion group two coronary artery lesion group three coronary artery lesion group（P〈0.05）;The sensitiveness,distinctness and accuracy of hs-cTnI ＋ CK-MB were higher than CK-MB（P〈0.05）;The accuracy of hs-cTnI ＋ CK-MB were higher than hs-cTnI（P〈0.05）.Conclusion It has important guiding significance in ACS diagnosis,type and lesion severity assessment by hs-cTnI ＋ CK-MB.

关 键 词：急性冠脉综合征 超敏肌钙蛋白Ⅰ 肌酸激酶同工酶 

分 类 号：R541.4[医药卫生—心血管疾病]