心肌损伤标志物的测定在急性心肌梗死中的临床应用

Clinical application of detection of myocardial injury markers in acute myocardial infarction.

目的:对心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)和肌红蛋白(Mb)进行定量分析比较,对急性心肌梗死(AMI)的早期诊断和风险预测提供较为可靠的检测指标。方法:对85例急性冠状动脉综合征患者(ACS)在入院后24 h内检测cTnI、CK-MB和Mb的质量水平,探讨它们对AMI的敏感性和特异性,并进行评估。结果:患者入院后24 h内cTnI、CK-MB和Mb对AMI的敏感性分别为93.3%,86.7%和78.3%,特异性分别为100%,100%和88.0%;同时检测cTnI和Mb时AMI的敏感性为96.7%,特异性为88.0%;同时检测cTnI、Mb和CK-MB时AMI的敏感性为98.3%,特异性为88.0%,阳性预期值为95.2%,阴性预期值为88.0%。结论:cTnI、CK-MB和Mb联合检测对诊断AMI具有高度的敏感性和特异性,而且cTnI可作为评估发生因心血管死亡事件的独立风险因子。

Objective：Quantitative analysis was performed for cardiac troponin I（cTnI）,creatine kinase（CK-MB） and myocardial myohemoglobin （Mb） so as to provide available detective index in the early diagnosis of acute myocardial infraction（AMI）and risk prediction. Methods： Mass of serum cTnI,CK-MB and Mb of 85 patients with acute coronary artery syndrome（ACS） were detected within 24h to discuss their sensitivity and specificity to AMI. Resalts：The spective sensitivity value of cTnI,CK-MB and Mb were 93. 3% ,86.7% and 78. 3% ; the spective specificity value were 100% ,100% and 88. 0% ;the sensitivity and specificity value of both cTnI and Mb were 96. 7% and 88. 0% ; the sensitivity and specificity value of all cTnI,Mb and CK-MB were 98. 3% and 88.0% ;the positive and negative expectative value were 95.2% and 88.0%. Conclusions：To AMI, there was most sensitive and specific to detect all of cTnI,CK-MB and Mb. cTnI was the individual risk factor by evaluating death occurrence for cardiovascular.