血清心肌酶谱、肌钙蛋白Ⅰ、肌红蛋白与脑钠肽的联合检测对临床诊断急性心肌梗死的意义  

Significance of combined detection of serum myocardial enzyme spectrum, cardiac troponin Ⅰ,myoglobin and brain natriuretic peptide in the clinical diagnosis of acute myocardial infarction

作　　者：陈四梅 田映雪 古文鑫 CHEN Si-mei;TIAN Ying-xue;GU Wen-xin(Department of Clinical Laboratory,Panyu District Shiqiao Hospital,Guangzhou 511400,China)

机构地区：[1]广州市番禺区市桥医院检验科,511400

出　　处：《中国实用医药》2020年第18期21-23,共3页China Practical Medicine

摘　　要：目的探讨对急性心肌梗死诊断时使用血清心肌酶谱、肌钙蛋白Ⅰ(cTnI)、肌红蛋白(MYO)与脑钠肽(BNP)的联合检测的效果。方法选择33例急性心肌梗死患者作为研究组,另选择同期30例健康体检者作为对照组,两组均进行血清心肌酶谱、肌钙蛋白Ⅰ、肌红蛋白与脑钠肽检测。比较两组心肌酶谱[血清肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBDH)、天门冬氨酸氨基转移酶(AST)]以及肌钙蛋白Ⅰ、肌红蛋白与脑钠肽的水平,并比较各指标的单项检测与多项检测的阳性检出情况。结果 33例急性心肌梗死患者,心肌酶谱+脑钠肽、心肌酶谱+肌红蛋白、肌红蛋白+脑钠肽、肌红蛋白+脑钠肽+肌钙蛋白Ⅰ、肌红蛋白+脑钠肽+肌钙蛋白Ⅰ+心肌酶谱的阳性检出率分别为72.73%、69.70%、66.67%、87.88%、100.00%,均高于心肌酶谱、肌钙蛋白Ⅰ、肌红蛋白、脑钠肽的42.42%、36.36%、39.39%、39.39%,差异具有统计学意义(P<0.05);肌红蛋白+脑钠肽+肌钙蛋白Ⅰ+心肌酶谱的阳性检出率高于心肌酶谱+脑钠肽、心肌酶谱+肌红蛋白、肌红蛋白+脑钠肽、肌红蛋白+脑钠肽+肌钙蛋白Ⅰ,肌红蛋白+脑钠肽+肌钙蛋白Ⅰ的阳性检出率高于肌红蛋白+脑钠肽,差异均具有统计学意义(P<0.05)。结论对急性心肌梗死诊断时使用血清心肌酶谱、肌钙蛋白Ⅰ、肌红蛋白与脑钠肽联合检测可以提高检出率,因此对于急性心肌梗死的诊断具有重要的临床意义。Objective To discuss the effect of combined detection of serum myocardial enzyme spectrum, cardiac troponin Ⅰ(cTnI), myoglobin(MYO) and brain natriuretic peptide(BNP) in the clinical diagnosis of acute myocardial infarction. Methods There was 33 cases of acute myocardial infarction patients selected as research group, and another 30 healthy persons in the same period selected as the control group. Both groups received combined detection of serum myocardial enzyme spectrum, cardiac troponin Ⅰ, myoglobin and brain natriuretic peptide. The levels of myocardial enzyme spectrum[serum creatine kinase(CK), creatine kinase isoenzyme(CKMB), lactate dehydrogenase(LDH), α-hydroxybutyrate dehydrogenase(α-HBDH), aspartate aminotransferase(AST)], cardiac troponin Ⅰ, myoglobin and brain natriuretic peptide were compared between the two groups. The results of single detection and multiple detection were compared. Results In 33 patients with acute myocardial infarction, the positive detection rates of myocardial zymogram + brain natriuretic peptide, myocardial zymogram + myoglobin, myoglobin + brain natriuretic peptide, myoglobin + brain natriuretic peptide + cardiac troponin Ⅰ, myoglobin + brain natriuretic peptide + cardiac troponin Ⅰ + myocardial zymogram were 72.73%, 69.70%, 66.67%, 87.88% and 100.00% respectively, which were all higher than 42.42%, 36.36%, 39.39% and 39.39% of serum myocardial enzyme spectrum, cardiac troponin Ⅰ, myoglobin and brain natriuretic peptide, and their difference was statistically significant(P<0.05). The postive detection rate of myoglobin + brain natriuretic peptide + cardiac troponin Ⅰ + myocardial zymogram was higher than that of myocardial zymogram + brain natriuretic peptide, myocardial zymogram + myoglobin, myoglobin + brain natriuretic peptide, myoglobin + brain natriuretic peptide + cardiac troponin Ⅰ, and the positive detection rate of myoglobin + brain natriuretic peptide + troponin Ⅰ was higher than that of myoglobin + brain natriuretic peptide, and their difference

关 键 词：急性心肌梗死 血清心肌酶谱 肌钙蛋白Ⅰ 肌红蛋白 脑钠肽 

分 类 号：R542.22[医药卫生—心血管疾病]