血清心肌肌钙蛋白I对心肌疾病的诊断价值  

The Diagnostic Value of Serum Cardiac Troponin I in Myoc ardial Disease

作　　者：姜坚[1] 程焕煜 蒋红丽[1] 章敏 徐琛华 赵美华[1] 荣烨之[1] 

机构地区：[1]上海第二医科大学附属新华医院心内科,200092 [2]江苏省滨海医院内科,224500

出　　处：《诊断学理论与实践》2002年第4期234-236,共3页Journal of Diagnostics Concepts & Practice

摘　　要：目的:探讨心肌肌钙蛋白I(cTnI)作为一种心肌损伤指标对急性心肌梗死(AMI)、不稳定型心绞痛(UA)及急性病毒性心肌炎(AVM)的诊断价值。方法:用抗人心肌肌钙蛋白T及抗人心肌肌钙蛋白I单抗,应用酶联免疫法同步测定23例AMI、14例UA和42例AVM病人的血清cTnT及cTnI,同时作肌酸磷酸激酶(CK)及其同工酶(CK鄄MB)检测。结果:23例AMI病人血cTnT和cTnI阳性率均为100%;14例UA病人血中cTnT阳性5例,cTnI阳性9例,cTnI和cTnT在37例AMI和UA病人中阳性率分别为86.5%及75.7%;42例AVM病人血cTnT阳性者16例,阳性率38.1%;cTnI阳性者27例,阳性率64.3%。2种心肌肌钙蛋白的阳性率在AMI病人与UA病人差异无显著性(P>0.05)。2种心肌肌钙蛋白的阳性率在AVM病人测定结果的差异有显著性(P<0.05)。CK、CK鄄MB在AMI22例及UA3例中为阳性,而AVM病人均正常。结论:cTnT与cTnI同样可作为心肌损伤的指标,cTnI与cTnT在AMI中出现时间较CK、CK鄄MB早,较CK、CK鄄MB灵敏且更显特异性。cTnI对AVM较cTnT更灵敏、更具特异性,是临床上值得推荐应用的检测指标。Objective: To evaluate the value of serum cardiac troponin I(cTnI)as a marker in diagnosing acute myocardial infarction(AMI),unstable angina pectoris(AP)and acute virual m yocarditis(AVM).Methods:The serum concentrations of cTnI,cTnT,creatine kinase(CK )and isoenzyme MB(CK-MB)were simultaneously measured by Immunoenzymatic assay i n23patients with AMI,14patients with AP and42patients with AVM.Results:In total3 7patients with AMI and AP,the positive rates of serum cTnT and cTnI were75.7%(28 /37)and86.5%(32/37)respectively,and in42patients with AVM were38.1%(16/42)and64. 3%(27/42)respectively.Positive CK and CK-MB concentration was found in22patient s with AMI and3patients with UA and normal range in all patients with AVM.Conclu sions:cTnT and cTnI could be used as a marker in diagnosis of myocardial damage, and they appear in serum earlier than CK and CK-MB.cTnI is more sensitive and s pecific in diagnosing AVM.

关 键 词：血清 心肌肌钙蛋白Ⅰ 诊断 心绞痛 心肌梗死 病毒性心肌炎 肌钙蛋白T 

分 类 号：R542.2[医药卫生—心血管疾病]