肌钙蛋白I定性检测在急诊科诊断AMI的应用价值

Application Value of the Qualitative Test of Serum Cardiac Troponin I in the Diagnosis of Myocardial Infarction in Emergency Department

【目的】评价肌钙蛋白I(cTn I)定性检测在急诊科诊断急性心肌梗死(AMI)的应用价值。【方法】对832例因急性胸痛疑诊为AMI的患者,于就诊即刻行cTn I定性检测,由确诊为心肌梗死和非心肌梗死患者的测定结果计算出cTn I检测对诊断心肌梗死的灵敏度和特异性,并按病人胸痛发作至入院就诊时间进行比较分析。【结果】在胸痛发作6 h内,cTn I定性检测的灵敏度为40.2%,特异性为97.5%,其灵敏度显著低于胸痛发作6 h后(P<0.01)。【结论】cTn I定性检测的阳性结果可为急性胸痛患者诊断AMI提供较为准确的诊断信息,但其阴性结果对排除心肌梗死的价值不大,尤其在胸痛发作6 h内。

[Objective]To evaluate the application value of the qualitative test of serum cardiac troponin Ⅰ （cTnⅠ） in the diagnosis of myocardial infarction（MI） in emergency department. [Methods]The qualitative analysis of cTnI was proceeded at 832 patients with a possible diagnosis of acute myocardial infarction in the emergency department. Sensitivity and specificity were calculated using the patients with definitely present or absent myocardial infarction. [Results]The sensitivity and specificity of the qualitative test of cTn I were 40.2%, 97.5%, respectively in the first six hours. The sensitivity was markedly lower in the first six hours than over six hours;[Conclusion]The positive result of qualitative test of serum cardiac troponin I gives positive diagnostic information in patients with AMI. But the negative result can not exclude myocardial infarction, especially in the first six hours after onset of symptoms.