床边即时检测技术检测cTnI联合CK-MB、Mb对急性心肌梗死的早期诊断效能分析  

Analysis of the early diagnosis efficacy of cTnI combined with CK-MB and Mb by POCT for patients with acute myocardial infarction

作　　者：杜宣莉 牛帅[1] 吴广福[1] 朱德才[1] DU Xuanli;NIU Shuai;WU Guangfu;ZHU Decai(Department of Emergency Medicine,Bozhou People's Hospital,Bozhou Anhui 236800,China)

机构地区：[1]亳州市人民医院急诊内科,安徽亳州236800

出　　处：《中国急救复苏与灾害医学杂志》2022年第7期853-855,868,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：安徽省重点研究与开发计划(第一批)项目(编号:皖科资秘[2021]230号);亳州市科研计划项目(编号:bzzc2020005)。

摘　　要：目的分析床边即时检测技术(POCT)检测肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、肌红蛋白(Mb)对急性心肌梗死(AMI)的早期诊断效能。方法回顾性分析2019年4月—2020年12月亳州市人民医院收治的137例拟诊为AMI患者的临床资料,根据心电图、心肌酶谱检测和冠状动脉造影检查结果分为AMI组和非AMI组。使用POCT技术检测并对比两组患者入院时的cTnI、CK-MB和Mb水平,使用受试者工作特征(ROC)曲线分析cTnI、CK-MB、Mb对AMI的早期诊断效能。结果137例患者中有88例AMI患者;POCT测定的AMI组cTnI、CK-MB和Mb水平明显高于非AMI组(P<0.05);POCT测定cTnI、CK-MB、Mb诊断AMI的最佳截断点(cut-off)分别为0.14 ng/mL、3.70 ng/mL、58.02 ng/mL,且各指标联合诊断AMI的灵敏度为100.00%,特异度与各指标对比差异无统计学意义(P>0.05),曲线下面积(AUC)均高于单独评估(P<0.05)。结论POCT技术能够快速、准确地检测心肌标志物,cTnI、CK-MB和Mb可作为AMI的早期诊断指标,对AMI的发生均有诊断价值,且联合诊断价值更高。Objective To analyze the early diagnostic efficacy of troponin I(cTnI),creatine kinase isoenzyme(CK-MB)and myoglobin(Mb)detected by point-of-care testing(POCT)in patients with acute myocardial infarction(AMI).Methods A retrospective analysis of the clinical data of 137 patients with suspected AMI admitted to Bozhou People′s Hospital from April 2019 to December 2020 were divided into AMI group and non-AMI group according to routine electrocardiogram,detection of myocardial enzyme spectrum and coronary angiography.The cTnI,CK-MB and Mb levels on admission of the two groups of patients were detected by POCT and compared.Receiver operating characteristic(ROC)curve was used to analyze the early diagnosis efficacy of cTnI,CK-MB and Mb for acute myocardial infarction.Results Among 137 patients,88 patients were AMI.The levels of cTnI,CK-MB and Mb detected by POCT in the AMI group were substantially higher than those in the non-AMI group(P<0.05).The best cutoff point values of cTnI,CK-MB and Mb in the diagnosis of AMI were 0.14 ng/mL,3.70 ng/mL and 58.02 ng/mL,respectively.The sensitivity of the combined diagnosis of AMI was 100.00%,the specificity was not statistically different from each index(P>0.05),and the area under curve(AUC)was higher than the individual evaluation(P<0.05).Conclusion POCT can quickly and accurately detect myocardial markers.cTnI,CK-MB and Mb can be used as early diagnostic indicators of AMI,and they have diagnostic value for the occurrence of AMI.The combined diagnostic value of indicators is better.

关 键 词：床边即时检测技术 肌钙蛋白Ⅰ 肌酸激酶同工酶 肌红蛋白 急性心肌梗死 诊断效能 

分 类 号：R542.22[医药卫生—心血管疾病]