心脏肌钙蛋白I测定在心血管疾病诊断中的初步应用

Preliminary application of detection of cardiac troponin I in diagnosis of cardiovascular diseases

目的探讨心脏肌钙蛋白Ｉ（ｃＴｎＩ）测定对心血管疾病心肌损伤的诊断价值。方法用固相层析免疫法测定急性心肌梗死（ＡＭＩ），心绞痛（ＡＰ）、病毒性心肌炎（ＶＭ）、原发性高血压（ＥＨ）和射频消融（ＲＦＣＡ）术后患者血清ｃＴｎＩ。结果 ＡＭＩ、 ＶＭ和 ＲＦＣＡ术后患者血清 ｃＴｎＩ阳性率显著高于正常人（Ｐ＜０．００５）。 ＡＭＩ组ｃＴｎＩ强阳性者较其他组显著增多（Ｐ均＜０． ００１）， Ｉ多数２周内转阴；而 ＶＭ组和 ＲＦＣＡ组弱阳居多（ Ｐ＝０． ２）， ＶＭ患者多于１个月左右转阴； ＲＦＣＡ术后 ７２ｈ内即可转阴。 ｃＴｎＩ测定敏感性高于心肌酶学（Ｐ＜０．００５）。结论 ｃＴｎＩ是一特异性和敏感性具佳的心肌损伤血清标志物，对不同病理改变及不同病理进程的心肌损伤之诊断具有重要应用价值。

To discuss the diagnostic value of cardiac troponin Ⅰ (cTnI) in detection of myocardial injury in cardiovascular diseases. Methods Solid-phase immunochromatographicassay was used to detect serum cTnI in patients with acute myocardial infarction (AMI), angina pectoris (AP), essential hypertension (EH) and viral myocarditis (VM), and the patients after radiofrequency catheter ablation (RFCA). Results The positive rate of cTnI in sera of patients with AMI, VM and the patients after RFCA were significantly greater than that in the normal (P<0.005). The cases of cTnI strong-positive in AMI group were higher than those in others while the cases of cTnI weak-positive increased highly both in VM groupsand in the group after RFCA (P= 0. 2). The time of cTnI turning negative was 2 weeks, 1 month and 3 days in major patients with AMI, VM and the patients after RFCA respectively The sensitivity of cTnI was superior to serum enzymes (P<0.005). Conclusion cTnI wasagood serum marker to evaluate myocardial injury, and it might be useful to diagnose myocardial injury in different pathological changes and processes.