血清肌钙蛋白T及I对急性心肌梗死早期诊断的临床价值  

Significance of cardiac troponin T and troponin I in the early diagnosis of myocardial infarction

作　　者：张亚臣[1] 赵美华[1] 吕宝经[1] 荣烨之[1] 许之民[1] 黄国芳[1] 

机构地区：[1]上海第二医科大学附属新华医院心内科,上海200092

出　　处：《临床心血管病杂志》2003年第2期72-74,共3页Journal of Clinical Cardiology

摘　　要：目的 :观察急性心肌梗死 (AMI)患者入院前后血清肌钙蛋白T(cTnT)、肌钙蛋白I(cTnI)的变化 ,探讨cTnT、cTnI对早期诊断AMI的价值。方法 :对 10 0例患者 (AMI 5 0例、不稳定型心绞痛 5 0例 )和 2 0例健康人进行了血清cTnT、cTnI、肌酸激酶 (CK)和肌酸激酶同工酶 (CK MB)检测。结果 :①血清cTnT、cTnI、CK和CK MB检测AMI的敏感度和特异度分别为 80 %和 90 %、85 %和 92 %、92 %和 6 1%、75 %和 75 %。②AMI患者血清cTnT、cTnI浓度平均升高 (17.5± 5 .7)和 (16 .2± 4 .8)倍 ,显著高于CK(7.6± 3.1)倍、CK MB (6 .5± 2 .9)倍 (P <0 .0 1) ;③AMI后 3h内cTnT、cTnI阳性检出率为 5 0 .0 %、4 0 .0 % ,明显高于CK MB(2 4 .0 % )和CK(2 0 .0 % ) ;AMI 5d后cTnT、cTnI阳性检出率为 70 .0 %、6 6 .0 % ,而CK MB和CK仅为 4 .0 %和 8.0 %。结论 :血清cTnT、cTnI能早期确切诊断AMI ,具有较宽的时间诊断窗口 。Objective:To investigate the early diagnostic value and significance of cardiac troponin T(cTnT) and troponin I(cTnI) in acute myocardial infarction (AMI).Methods:Serum from 100 patients with coronary heart disease(AMI) 50 cases, unstable angina pectoris (UAP) 50 cases and 20 healthy controls were examined for cTnT, cTnI, CK and CK MB by enzyme immunosorbart assay and other physiochemical methods.Results:①The sensitivity and specificity of cardiac damage were 80% and 90% for cTnT; 85% and 92% for cTnT; 75% and 75% for CK MB; 92% and 61% for CK respectively. ② In AMI group, the concentration of cTnT and cTnI rose up to 17.5 ± 5.7 times and to 16.2 ± 4.8 times, which were significantly higher than that of CK( 7.6 ± 3.1 ) times and CK MB ( 6.5 ± 2.9 ) times (P< 0.01 ). ③ In the 3 h after AMI, the positive rates of cTnT ( 50.0 %) and cTnI ( 40.0 %) were significant higher than CK ( 24.0 %) and CK MB ( 20.0 %). In the 5 day after AMI, the positive rates were 70% for cTnI; 66% for cTnT; 4% for CK MB and 8% for CK. Conclusion:The serum level of cTnT and cTnI can closely reflect the extent of myocardial damage in AMI. It provides a early diagnostic window for detection of AMI than CK and CK MB. Serum level of cTnT and cTnI are markers with high sensitivity and specificity for AMI and can aid in the early diagnosis of AMI.

关 键 词：心肌梗死 肌钙蛋白 肌酸激酶类 肌酸激酮工酶类 

分 类 号：R542.2[医药卫生—心血管疾病] Q593.3[医药卫生—内科学]