急性心肌梗死患者血清肌钙蛋白的变化及对溶栓后冠脉再通的判定

Diagnosis of change of serum calcium muscle protein and thrombolytic recanalization

目的观察急性心肌梗死(AMI)患者接受静脉溶栓治疗血清蛋白-肌钙蛋白I(cTnI)的变化及其评价溶栓后冠脉再通的价值。方法 66例AMI者均接受静脉溶栓治疗,应用ELISA法测定cTnI值。结果溶栓再通组52例,溶栓未通组14例,两组的cTnI释放大部分存在双峰,溶栓再通组第一峰时(11.34±3.2)h、第二峰时(23.80±12.42)h,比未通组相对应的时间明显提前(P<0.05),cTnI第一峰时比CK-MB峰时提前。以cTnI第一峰值到达时间≤14h判定溶栓再通的敏感性、特异性及准确性分别为92.31%、64.29%及66.5%。结论在大多数AMI患者血清cTnI释放呈双峰,其第一、二峰值到达时间在溶栓再通组前移,血清cTnI≤14h作为评价溶栓再通与否,有一定的判定价值。

Objective To observe the effect of acute myocardial infarction（AMI） patients receiving thrombolytic therapy of cardiac troponin I（cTnI） concentrations and evaluation of changes in the value of thrombolytic reperfusion.Methods Totally 66 patients with AMI receiving thrombolytic therapy,applied ELISA method cTnI values.Results Totally 52 cases of reperfusion after thrombolysis group,14 cases thrombolysis did not pass,the cTnI release most of the existence of two peaks,the first peak group thrombolytic recanalization time（11.34±3.2） h,the second peak（23.80±12.42） h,than the group did not pass ahead of the corresponding time was significantly（P0.05） ,cTnI during the first peak earlier time than CK-MB peak.The arrival time of the first peak cTnI ≤14h thrombolytic recanalization determine the sensitivity,specificity and accuracy were 92.31%,64.29% and 66.5%.Conclusions In most AMI bimodal serum cTnI release,the first and second peak arrival time in the forward thrombolytic recanalization group,serum cTnI ≤14 hours as an evaluation of reperfusion after thrombolysis or not,have a certain decision value.