急性心肌梗死发病时间与心脏标记物敏感性之间的相关性分析

Relationship between the sensitivity of cardiac markers and the symptom duration in patients of acute myocardial infarction

目的探讨急性心肌梗死(AMI)患者的发病时间与三种常用的心脏标记物敏感性之间的关系。方法将症状提示有急性冠状动脉综合征(ACS)可能的就诊患者按症状持续的时间分为两组(<6h组和6~24h组),分别测定就诊即刻(0h)和就诊2h患者的血清磷酸肌酸激酶(CK)、磷酸肌酸激酶同工酶(CK-MB)和肌钙蛋白T(cTNT)。比较两组患者三种标记物的敏感性。结果在就诊即刻(0h),症状持续时间6h以上的患者三种标记物明显高于症状持续时间短(<6h)的患者。在就诊2h,敏感性没有显著差异。结论症状发作6h以上的患者,在到达急诊室0h测定的血清心脏标记物的敏感性显著高于症状发作时间少于6h的患者;尤其是cTNT,敏感性增加3倍。

Objective To investigate the relationship between the sensitivity of cardiac markers and the symptom duration. Methods We divided all adult patients who presented to our Emergency Dcpartment（ED） with symptoms suggesting of acute myocardial irfarction（AMI ） into two groups. Patients in one group came to the ED late（ 6-24h） after their symptom＇ s onset,and the other patients in another group arrived earlicr（ 〈6h）. We drew serum sarnplc for creatine phosphokinase （CK） ,CK-MB, and troponin T upon arrival（ time 0）and 2h later. Compared the sensitivity of three commonly used cardiac markers between two groups. Results For time 0, the sensitivity of all three markers for acute MI was signifieandy higher among those subjects with symptoms of 6 or more hours＇ duration as compared to those with less. At the time of the 2-h sample, the differences in sensitivities were much less and were not statistically significant. Conclusion The cardiac marker values obtained at time 0 among Emergency Deparunent patients who arrive 6 or more hours after cardiac symptom onset provide signifieandy higher sensitivities as compared to those obtained in patients who arrive earlier. For troponin T, the increase in sensitivity approaches threefold.