床边快速Myo、CK-MB、cTnI三项联合检测对心肌挫伤急诊早期诊断价值的临床研究

The clinical research of the value of Rapid bed-bedside Myo,CK-MB,cTnI three combined detection in emergency early diagnosis for myocardial contusion

目的研究床边快速Myo、CK-MB、cTnI三项联合检测对心肌挫伤急诊早期诊断的价值。方法选择笔者所在医院急诊科2008年10月～2010年1月在创伤急诊室就诊的钝性胸部外伤患者或合并钝性胸部外伤并除外诊断明确的原发性心脏疾病或肺部疾病的患者和开放性胸部创伤的患者120例,对收住院的患者进行追踪动态观察患者的症状体征、Myo、cTnI、CK-MB三项酶学变化、心电图改变、彩色超声检查做出明确诊断。比较床边快速三项酶学联合检测与同期结合心电图、心脏彩超检查结果对心肌挫伤急诊室早期诊断的敏感性、特异性;比较床边快速三项酶学联合检测与入院后确诊为心肌挫伤的敏感性、特异性。结果 CK-MB、cTnI对心肌挫伤有较高的特异度,Myo升高时间最快,并且达到峰值时间和恢复到对照组水平时间均最短。结论笔者所在科室应用床边快速心梗诊断仪能提供快速的床旁诊断平台,操作简单、方便,检验结果快速准确,对心肌挫伤的早期诊断有重要意义。

Objective To study the value of Rapid bed-bedside Myo Ck-MB cTnI three combined detection in emergency early diagnosis for myocardial contusion.Methods Selecting 120 patients treated in the emergency trauma room of our hospital during October 2008-January 2010,including blunt chest trauma except for a clear diagnosis of primary heart disease or lung disease and open chest trauma.The hospitalized patients were observated with symptoms and signs,Myo,cTnI,CK-MB three kinds of enzyme changes,ECG changes,color Doppler ultrasound examination and were made a clear diagnosis by these.To compare the sensitivity and specificity for the early diagnosis of myocardial contusion in the emergency room between Rapid bed-bedside Myo,CK-MB,cTnI three combined detection and combined with ECG,echocardiography test during the same period.To analyze the sensitivity and specificity of Rapid bed-bedside Myo,CK-MB,cTnI three combined detection myocardial contusion after the inpatients were final diagnosed.Results CK-MB,cTnI had a high specificity for myocardial contusion.Myo rised fastestly,and the peak time and the time returned to control group＇s levels were both shortest.Conclusion Our department can provide rapid bed-beside platform by Rapid bed-bedside Myo,CK-MB,cTnI three combined detection.The Cardiac Panel contains Myo,CK-MB,CTnI and other myocardial injury markers simultaneously quantitative analysis.It is convenient and have fast and accurate test results,and it is very important for the early diagnosis of myocardial contusion.