急性心肌梗死患者心肌损伤标志物动态监测价值的比较

Comparative Study on the Values of Dynamic Detection of Two-panel Myocardial Injury Markers in Patients with Acute Myocardial Infarction

为探讨两组心肌损伤标志物对AMI的早期诊断和预后评估的价值，采用化学发光免疫分析法、免疫比浊法和酶学速率法对79例AMI（急性心肌梗死）组患者和40例非AMI组患者2、4、8、12、24h和2、4、7、14d的血清或血浆进行蛋白肽类标志物（Myo、cTnI、hs．CRP、BNP）和心肌酶学标志物（CK．MB、LDH、AST、α-HBDH）水平的动态测定。结果表明AMI组患者血清或血浆中两组标志物均明显高于非AMI组，具有显著性差异（P〈0．01）；AMI患者在发病2—4h后联合监测Myo、cTnI、hs—CRP和BNP阳性率明显高于CK—MB、LDH、AST和α-HBDH具有显著性差异（P〈0．01）。以上数据表明Myo、cTnI、hs—CRP和BNP联合测定对AMI作出更准确早期诊断，有较高的临床应用价值。

To study the values of detection of two-panel myocardial injury markers in the early diagnosis and prognosis patients with acute myocardial infarction （ AMI）, the serum or plasma levels of protein-peptidic markers （Myo, cTnI, hs-CRP and BNP） and myoenzymatic markers （ CK-MB, LDH, AST and α-HBDH） in 79 pa- tients with AMI and 40 non-AMI patients were measured by Chemiluminescence immunoassay, immunoturbidimetry and enzymatic rate method at 2, 4, 8, 12 and 24 hours and 2, 4, 7 and 14 days. The results showed that the serum or plasma levels of two-panel injury markers in patients with AMI were significantly higher than those in non-AMI （P 〈 0. 01 ）. The positive rates of Myo, cTnI, hs-CRP and BNP in AMI patients were markedly higher than those of CK-MB, LDH, AST and α-HBDH during 2 to 4 hours after AMI （P 〈 0. 01 ）. The data indicated that the combined detection of Myo, cTnI, hs-CRP and BNP may be more accurately in the early diagnosis of AMI and have a higher clinical value.