急性心肌梗死患者血清心肌肌钙蛋白Ⅰ的表达及其临床意义

Expression and clinical value of cardiac troponin Ⅰ in acute myocardial infarction

目的探讨心肌肌钙蛋白Ⅰ（cTnⅠ）水平对急性心肌梗死（AMI）临床诊断和治疗中的意义。方法选择临安市人民医院（以下简称“我院”）2011年8月～2013年5月收治的AMI患者60例，作为实验组；另外选取同期在我院接受体检的60名健康体检者作为对照组。采用非均相免疫法检测患者的cTnⅠ、肌红蛋白（Mb）和肌酸激酶同工酶（CK—MB）水平。AMI患者口服阿司匹林、β受体阻滞剂和血管紧张素转换酶抑制剂（ACEI）治疗，并分析cTnⅠ水平与预后的关系。结果实验组cTnⅠ、Mb和CK—MB含量分别为（1．150±0．120）μg/L、（423±187）μg/L和（1521．9±382．8）U／L，均明显高于对照组[（0．016±0．007）μg/L、（90±58）μg/L和（215．9±42.3）U/L]，差异有统计学意义（P〈0．05）；疗效评价为显效和有效患者的cTnⅠ水平分别为（0．021±0．008）μg/L和（0．132±0．225）μg／L，而无效的为（1．018±0．124）μg／L，无效患者cTnⅠ水平明显高于显效和有效，差异有统计学意义（P〈0．05）。结论cTnⅠ水平的检测可以作为AMI诊断的重要指标和依据，同时也可以作为预后情况的判断标准，应该加以推广。

Objective To explore the value of cardiac troponin Ⅰ （cTnⅠ ） in the diagnosis and treatment of Acute myocardial infarction （AMI）. Methods 60 patients with AMI in the People＇s Hospital of Lin＇an City （＂our hospital＂ for short） from August 2011 to May 2013 were selected as the experimental group; and another 60 cases of healthy accepted a medical examination in our hospital over the same period were selected as the control group. Levels of cTnⅠ , Mb and CK-MB in patients were detected by heterogeneous immunoassay. AMI patients were received aspirin, β-blockers and ACEI therapy, the relationship between cTnⅠ level and prognosis was analyzed. Results cTnⅠ , Mb and CK-MB levels were （1.150±0.120） μg/L, （423±187） μg/L and （1521.9±382.8） U/L in the experimental group, which were significantly higher than those in the control group [（0.016±0.007）μg/L, （90±58） μg/L and （215.9±42.3） U/L], the differences were statistically significant （P 〈 0.05）; cTnⅠ level in patients with markedly effective and effective were （0.021± 0.008） μg/L and （0.132±0.225） μg/L, while was （1.018±0.124） μg/L in ineffective patients, cTnⅠ level in ineffective patients was significantly higher than that in markedly effective patiens and effective patients, the difference was statistically significant （P 〈 0.05）. Conclusion Detection of cTnⅠ levels can be used as an important indicator of in diagnosis of cardiovascular disease, but also can be used as criteria for determining prognosis and should be promoted.