摘要
目的:探讨心肌三项在早期诊断急性心肌梗死(AMI)中的价值。心肌三项包括肌钙蛋白T(cTnT)、肌红蛋白(Mb)和肌酸激酶同工酶(CKMB)。方法:回顾近年收治的AMI患者76例,男55例,女21例,平均年龄63.24±20.21岁,有较明确的发病时间,检测cTnT、Mb、CKMB,对上述指标进行对比研究。结果:胸痛发作时间在4小时以内、4小时、5～11小时及大于12小时首次测定cTnT阳性率分别为41.18%、50.00%、52.38%和47.37%,测定Mb阳性率分别为81.18%、86.12%、51.38%和42.37%,测定CK-MB阳性率分别为70.59%、85.71%、95.24%和89.47%,Mb在胸痛发作8小时达最高峰,12小时开始下降。CK-MB在各时间段阳性率均达到70%以上,且阳性率随胸痛发作时间有逐渐上升趋势,而Mb的阳性预测值明显高于cTnT的阳性预测值(P<0.01),但与CK-MB的阳性预测值差异无统计学意义(P>0.05)。结论:心肌三项在AMI早期诊断中具有较高的特异性和灵敏度,三者结合可能提高早期AMI的诊断率,避免不典型患者的漏诊。
Objective：To investigate the value of serum cardiac troponin T（cTnT） ,myoglobin（Mb） and creatine kinase isoenzyme MB （CKMB） levels in the early diagnosis of the patients with acute myocardial infarction （ AMI ）. Methods： 76patients （ 55males and2l females, mean age63.24 ± 20. 21years）admitted to the hospital suffering from AMI were studied in a retrospective analysis. Among them. The symptoms of chest pain were recorded, eTnT, Mb, CKM- Bwere examined on admission. Results：The time of onset of chest pain was divided into 4 segments of 〈 4hours, 4hours, 5 - 11 hours and 〉 12hours. The positive rate of cTnT in the determination was41. 18%, 50. 00%, 52. 38% and47. 37%, The positive rate of Mb in the determination was81.18%, 86. 12% ,51.38%和42. 37% ,while that of CK - MB was70. 59% ,85. 71% ,95.24% 和11 89.47%, Mb was top when the time of onset of chest pain was 8hours, Mb started to descend after the time of onset of chest pain was 12hours. The overall positiverate of CK -MB was higher than70%. According to the time of the episodes of chest pain, the positive rate tended to rise as well. The posi- tive rate of Mb was higher than that of cTnT （P 〈 0. 01 No significant differennee was observed in the positive rate Mb and CK - MB P 〉 0. 05 ）. Conclusion： Mb, cTnT and CK - MB have a high specificity and sensitivity in the earlydiagnosis of AMI. If they are measured together, the early diagnosis rate may beimproved, and miss in the diagnosis of atypical patients can be avoided.
