肌钙蛋白Ⅰ在急性心肌梗死早期诊断和心肌再梗死中的价值

The early diagnostic value of cardiac troponin I in acute myocardial infarction and myocardial reinfarction

目的探讨心肌肌钙蛋白I(cTnI)在急性心肌梗死(AMI)早期诊断和心肌再梗死中的价值。方法测定131例AMI发作2～10 h患者的血清cTnI和肌酸激酶同工酶(CK-MB)的浓度,并以122名健康体检者作对照,绘制并分析受试者工作特征(ROC)曲线。结果AMI组发病早期血清cTnI和CK-MB水平与对照组相比差异有统计学意义(P<0.01);AMI后2～10 h cTnI和CK-MB的ROC曲线下面积(AUC)分别为:0.925、0.991、0.998和0.648、0.719、0.831;在AMI后2～10 h cTnI和CK-MB各指标临界值对应的敏感度分别为90.6%、97.6%、97.7%和54.1%、56.9%、76.9%;特异度分别为87.3%、95.4%、98.5%和87.3%、93.5%、88.1%;AMI发作10 h的患者若cTnI>20.1μg/L时,心肌再梗死与cTnI相关性良好(r=0.74)。结论cTnI在AMI早期诊断和预测再梗死中有一定的应用价值。

Objective To investigate the early diagnostic values of cardiac troponin Ⅰ （cTnI） in acute myocardial infarction（AMI）. Methods The levels of cTnI and MB isoenzyme of creatine kinase （CK-MB） in 131 patients with AMI from 2 h to 10 h were detected, in comparison with 122 normal controls. The results were analyzed according to receiver operating characteristic （ROC） curve. Results The levels of cTnI and CK-MB in AMI group was higher than control group（P 〈 0.01 ）. 2 to 10 h after AMI, the area under ROC curve were 0.925,0. 991,0.998,0.648,0.719 and 0.831 respectively. The borderline value of sensitivity of cTnI and CK-MB from 2 to 10 h after AMI were 90.6%, 97.6% ,97.7% ,54. 1% ,56.9% and 76.9% respectively. The specificity were 87.3% ,95.4% ,98.5% ,87.3%, 93.5% and 88.1% respectively. If the level of cTnI was higher than 20.1 μg/L in 10 h after AMI, there was a good relativity between cTnI and myocardial reinfarction （ r = 0.74）. Conclusions The cTnI detection is use for early diagnosis of AMI and may predict myocardial reinfarction.