肌钙蛋白I和CK_MB定量检测对急性心肌梗死的诊断价值

目的评估肌钙蛋白I(cTnI)及肌酸激酶同工酶(CK-MB)在急性心肌梗死(AMI)诊断中的价值。方法回顾本院近年收治的AMI病人100例(男72例,女28例),平均年龄58±3岁,有较明确的发病时间;正常健康人(排除心脏疾病患者)100例,(男76例,女24例),平均55±2岁;检测心肌酶学、1cTnI,对上述指标进行对比研究。结果100例AMI患者发病后4～6小时,cTnl明显高于0.16ug/L,16～24小时达到峰值,可持续7～10天。患者发病后6～8小时检测CK_MB开始升高,16～24小时达到峰值,48小时后开始下降并逐渐恢复正常。AMI组cTnl均大于正常值,对照组3例大于正常值,cTnl对AMI诊断的敏感性为100.0%(100/100),特异性为97.0%(97/100);AMI组CK_MB均为大于正常值,对照组20例大于正常值,CK_MB对AMI诊断的敏感性为100.0%(100/100),特异性为80.0%(80/100)。两者无显著性差别("P>0.05")。结论cTnl是诊断AMI最好的方法,CK-MB、cTnI在AMI诊断中具有较高的特异性和灵敏度,二者结合可提高AMI的诊断率,为梗死时间提供必要的信息。

Objective To evaluate the significance of CK-MB and cTnI in the early diagnosis of acute myocardial infarction （AMI） in the seniles . Methods 100 patients （72males and 28 females, mean age 58±3years） admitted to the hospital suffering from AMI were studied in a retrospective analysis. 100 normal healthy people （ exclude patients with heart disease .76males and 24 females）, mean age 55±2years;Detection CK-MB and cTnI ,Objective to evaluate the significance of CK-MB and cTnI. Results ：for 100 patients with AMI After 4-6hours of onset, the aquantity of cTnI is higher than 0.16ug/L,to reach the peak at 16-24 hours.last for 7-10days.for 100patients,theaquantityofCK-MBbeginstoriseafter 6-8 hours,reach the peak at16-24 hours,startingtodecline after 48 hours,Gradually.returning.to.normal .The aquantityof all the AMI patients is higher than the normal ,Only the aquantity of the three patients is higher in the control group.The sensitivity of diagnosis of cTnT toAMIisl00%（100/100）,Thespecifici ty..is..97.0%（97/100）, The aquantity of CK-MB of all the AMI patients is higher than the normal in the AMI patients group, Only theaquantity.. of.the..20..patientsishigherin.the.control, group .The sensitivity of diagnosis of CK-MB to AMI.is 100% （ 100/100）,Thespecificity is 80%（80/100）,There is no significant difference in both groups.（P〉0.05）Conclusion：cTNI is the best method of the diagnosis of AMI. CK-MB and cTnl both have a high specificity and sensitivity in the early diagnosis of AMI.If they are measured together, the early diagnosis rate may be improved, and some information of the infarction＇s moment may be provided.