心脏肌钙蛋白I测定在心肌损伤诊断中的应用

Application of Detection of Cardiac Troponin I in Diagnosis of Myocardial Injury

目的 探讨心脏肌钙蛋白I(cTnl)测定在心肌损伤诊断中的应用。方法 对 32例急性心肌梗死 (AMI)、2 8例病毒性心肌炎 (VM)、30例心绞痛 (AP)、30例原发性高血压 (EH)患者及 2 5例正常健康人血清cTnI、CK、CK MB、LDH测定。结果 ①AMI、VM患者 2 4h血清cTnI阳性率 (96 .9%、89.2 % )显著高于AP组、EH组、正常对照组 (16 .7%、0、0 ,P <0 .0 5 )。②AMI患者3h内血清cTnI阳性率 5 0 .0 % ,显著高于CK、CK MB、LDH阳性率 (18.8%、2 5 .0 %、2 1 9% ,P <0 .0 5 )。AMI患者 7d、10d后血清cTnI阳性率 6 0 .0 %、5 1 7% ,显著高于CK ,CK MB阳性率 (16 .7%、6 9% ;13 3%、3.4 % ,P <0 0 1)。③VM患者 2 4h内血清cTnI阳性率 75 .0 % ,显著高于CK ,CK MB、LDH阳性率 (5 3.6 %、6 0 .7%、2 1.4 % ,P <0 .0 5 )。VM患者 1w、2w、3w血清cTnI阳性率 88.9%、72 0 %、36 4 % ,显著高于CK ,CK MB阳性率 (2 5 .9%、2 0 .0 %、4 5 % ;2 9.6 %、2 4 .0 %、9 0 % ,P <0 .0 1)。结论 血清cTnI能早期确诊AMI、VM ,具有较宽的时间窗口 ,对心肌损伤的早期诊断优于心肌酶学 ,是较敏感和特异的血清标志物。

Objective To discuss the diagnostic value of cardiac troponin I (cTnI) in detection of myocardial injury in cardiovascular diseases.Methods Serum from patients with acute myocardial infarction (AMI) 32 cases, viral myocarditis (VM)28 cases, angina pectoris (AP)30 cases, essential hypertension (EH)30 cases and 25 cases healthy controls were examined for cTnI, CK, CK-MB, LDH. Results ①In the 24h after the patients were in the hospital,the positive rates of cTnI(96. 9%, 89. 2%) in the sera of patients with AMI,VM were significantly higher than AP, EH and controls (16. 7%, 0, 0, P<0.05).②In the 3h after the patients were in the hospital,the positive rates of cTnI(50.0%) in the sera of patients with AMI were significantly higher than CK, CK-MB, LDH (18.8%, 25.0%, 21.9%, P<0.05). In the 7d, 10d after the patients were in the hospital,the positive rates of cTnI(60.0%, 51.7%) in the sera of patients with AMI were significantly higher than CK, CK-MB, LDH (16.7%, 6.9%; 13.3%, 3.4%,P<0.01) .③In the 24h after the patients were in the hospital,the positive rates of cTnI(75.0%) in the sera of patients with VM were significantly higher than CK, CK-MB, LDH( 53.6%, 60.7%, 21.4%,P<0.05).In the 1w, 2w, 3w after the patients were in the hospital,the positive rates of cTnI(88.9%, 72.0%, 36.4%) in the sera of patients with VM were significantly higher than CK, CK-MB, LDH (25.9%, 20.0%, 4.5%; 29.6%, 24.0%, 9.0%,P<0.01).Conclusion The serum level of cTnI can closely reflect the extent of myocardial damage in AMI. It provides a longer diagnostic window for detection of AMI,VM. Cardiac troponin I (cTnI),which is superior to other myocardial enzymes in the early diagnosis of myocardial injury, serves as a serum marker with high sensitivity and specificity.