心肌肌钙蛋白Ⅰ和肌酸激酶MB同功酶的检测在急性心肌梗死早期诊断中的临床价值

Clinical values of detection of cTnI and CK-MB in early diagnosis of acute myocardial infarction

目的探讨心肌肌钙蛋白Ⅰ(cTnI)检测在早期诊断急性心肌梗死(AMI)中的临床价值。方法检测30例AMI患者,35例不稳定性心绞痛(UAP)患者,30例骨骼肌损伤(SM)患者血清cTnI、CK-MB含量,与30例门诊健康体检者做对照比较;并对AMI患者在胸痛发生不同时段进行动态检测。结果AMI组与对照组相比,cTnI和CK-MB含量均明显升高差异有极显著性P<0.01,AMI组与UAP和SM组比较,cTnI含量仍显著升高差异有极显著性P<0.01,而CK-MB含量差异无显著性P>0.05;cTnI在AMI发生4小时内就显著升高,二者的最高峰值在8～16小时内均可出现,72小时后,cTnI和CK-MB降至临界水平,而cTnI在7天后仍高于对照组。结论cTnI诊断AMI敏感性高,特异性强,在血清中出现时间早,持续时间长,有着更宽的诊断时间窗,诊断有效性明显优于CK-MB,对AMI患者的早期诊断和预后判断有较好的临床价值。

Objective To investigate the clinical value of cTnI in early diagnosis of AMI. Methods Given 3 groups of patients： 30 AMI patients, 35 UAP （Unstable Angina Pectoris） patients and 30 SM （skeletal muscles damage） patients, the content of cTnI and CK-MB for the above groups were examined, The results were compared with that of normal controls （30 healthy people）, For the AMI group,examinations were carried out at various times when chest pain presented. Results Compared with normal controls ,the cTnI content and the CK-MB content for the AMI group were evaluated remarkably. The values of the content differences were significant （P〈0.01）, Compared with the UAP group and the SM group, the cTnI content for the AMI group was elevated remarkably and the value of the content differences was significant （P〈0.01）. However, the CK-MB content difference was insignificant （P〉0.05）, When AMI occurred, within 4 hours,the cTnI content were elevated remarkably,and the two peak values appeared within 8 to 16 hours, After 72 hours, both the cTni content and the CK-MB content fell to the normal （critical） level, However, after 7 days, the cTnI content still remained higher than that of normal controls. Conclusion cTnI plays a sensitive and specific role in diagnosing AMI patients, Because cTnI presents itself earlier and lasts longer in the blood serum, cTnI can provide a much broader diagno- sis timeframe, cTnI in diagnosing AMI is much effective than that of CK-MB. cTnI is provod to have good clinical value in the early diagnosis and the prognosis of AMI patients.