肌红蛋白和心肌肌钙蛋白I联合快速检测对急性心肌梗死的早期诊断价值

Rapid Quantitative Analysis of Myohemoglobin and Cardiac Troponin I for Early Diagnos is of Acute Myocardial Infarction

目的探讨两种心肌损伤标志物肌红蛋白(Mb)及心肌肌钙蛋白I(cTn I)联合快速检测定性分析对急性心肌梗死(AMI)的早期诊断价值。方法因胸痛发作发病3h～6h,临床疑诊为AMI的病人120例。入院后即刻在床边采集静脉血测定Mb和cTn I,比较Mb、cTn I诊断AMI的敏感性、特异性、准确性、阳性预测值和阴性预测值。结果Mb的敏感性、阴性预测值均为100.0%,cTn I为94.4%和92.0%,Mb明显高于cTn I(P<0.05或P<0.01);而cTn I的准确性、特异性和阳性预测值分别为95.0%、95.8%和97.1%,Mb为83.3%、58.3%和78.3%,cTn I明显高于Mb(P<0.05或P<0.01);采用Mb联合cTn I检测,其特异性达到100.0%,高于单纯Mb和cTn I检测,有统计学意义(P<0.01)。结论Mb及cTn I快速联合检测有助于早期诊断或排除AMI,方法简便快捷,适合于急诊及院前急救。

Objective To investigate the value of rapid quantitative analysis of myohemoglobin （Mb） combined with cardiac troponin I （cTn I） in early acute myocardial infarction （AMI）. Methods One hundred and twenty patients with chest pain for 3 - 6 hours were diagnosed as AMI. Venous blood were collected at bedside after hospital admission and Mb, cTn I were determined. Sensitivity, specificity, accurate rate and predictive value were compared. Resuits The sensitivity and negatively predictive value were 100.0% for Mb, and 94.4 % and 92.0 % for cTn I. There was a significant difference（P 〈 0.05 or P〈0.01 ）;The accurate rate, specificity and positively predictive value for cTn I were 95.0 %, 95.8 % and 97.1%, respectively, for Mb were 83.3 %, 58.3 % and 78.3 %. There were significant difference（ P 〈 0.05 or P 〈 0.01 ） ; The specificity of Mb combined cTn I was 100 %, it was higher than any other single index of Mb or cTn I（P 〈 0.01）. Conclusion Rapid quantitative analysis of Mb combined with cTn I might make early diagnosis for AMI. The approach is convenient and shortcut, and suit emergency and pre- hospital diagnosis of AMI.