肌钙蛋白I及肌钙蛋白T在心肌梗死溶栓治疗中的检测应用

Detection use of cardiac troponin I and cardiac troponin T in thrombolysis therapy of acute myocardial infarction

目的:探讨心肌肌钙蛋白I(cardiac troponin I,cTnI)和肌钙蛋白T(Cardiac Troponin T,cTnT)的检测在急性心肌梗死(Acute Myocardial Infarction,AMI)溶栓治疗中的应用价值。方法:对86例AMI患者(AMI溶栓再通组44例、溶栓未通组42例)进行血清cTnT、cTnI、肌酸激酶(Creatine Kinase,CK)和肌酸激酶同工酶(CK-MB)的检测。结果:不同时间点,血清cTnT、cTnI的阳性检出率均高于同时期CK和CK-MB的阳性检出率;溶栓再通组cTnI、cTnT峰值较未通组显著增高,且峰值时间提前(P<0.05)。再通组cTnI、cTnT恢复正常的时间均提前于未通组(P<0.05,P<0.05)。结论:cTnI、cTnT检测AMI的敏感性和特异性都高于CK、CK-MB;溶栓后动态监测血清cTnI、cTnT浓度、峰值时间,对于正确判断AMI患者溶栓治疗后冠状动脉是否再通及进一步指导治疗有重要意义。

Objective ：To explore the value of cardiac troponin I （cTnI） and cardiac troponin T （cTnT） in the thrombolysis treatment of acute myocardial infarction （AMI）. Methods：Sera from 86 patients with AMI, the thrombolytic recanalized group 44 cases,the throm-bolytic non-recanalized group 42 cases, were examined for cTnT,cTnI,CK and CK-MB.Results：At different time points,the positive rates of cTnT and cTnI were higher than that of CK and CK-MB. The peak value of cTn I and cTnT in thrombolyfic recanalyzed group was much higher than that in thrombolytic non-recanalized group. Besides,the peak value of thrombolytic recanalyzed group was earlier than that of the thrombolytic non-recanalized group. The average time returning to normal for cTnI and cTnT in recanalized group was less than that of the thrombolytic non-recanalized group（P〈0.05, P〈0.05）. Conclusion ：The sensitivities and specificities of cTnI and cTnT are higher than that of CK and CK-MB. The dynamic monitoring levels of cTnI and cTnT in serum and the peak value time are meaningful in judging the coronary artery recanalization and providing further treatment guidelines.