几种常见心肌损伤生化标记物应用价值的比较和分析

The comparison and analysis of several biomarkers for myocardial damage

目的通过对心肌损伤患者进行不同的实验指标的检查,探讨几种常见心肌损伤生化标记物的应用价值。方法采用AU640自动生化仪检测肌红蛋白(Mb),肌酸激酶同工酶(CK-MB),心肌肌钙蛋白I(cTnI),血同型半胱氨酸(Hcy),脑利钠肽前体(pro-BNP),对其在心肌损伤疾病中的价值进行比较和分析。结果 Mb检测在心肌损伤早期快速方面,是最早可测的标记物。cTnI的诊断窗口期最长,有较好的跟踪性,且是特异性最好的标记物。CK-MB应用最广,但是其特异性较差。Hcy可以在冠心病的早期检测出其活动,对冠心病的预防及治疗有着重要的临床意义。脑利钠肽前体(pro-BNP)有助于早期诊断心肌损伤,可以反映心肌损伤的严重程度,可以作为心血管事件预测指标。结论心肌损伤疾病的患者,血浆中Mb、CK-MB、cTnI、Hcy、pro-BNP不同时段及治疗前后的水平变化,说明上述生化标记物参与疾病的发生,发展并与其疗效观察有密切的关系。四项指标同时的检测可互为补充,提高临床诊断价值。

Objective To investigate the clinical value of several myocardial biomarkers by determination of these biomarkers in patients with myocardial damage. Methods Myoglobin （Mb）, creatine kinase MB isocnzyme （CK- MB）, cardiac troponin I （cTnI）, homocysteic acid （Hcy）, and pro -brain natriuretic peptide （pro -BNP） were examined with AU640 biochemistry analyzer. The value of these biomarkers in the diagnosis of myocardial damage were compared and analyzed. Results Mb was detected at the earliest stage of myocardial damage. The window phase of cTnI detection was the longest, and facilitate the follow - up of the disease. The specificity of CK - MB was poor. Hcy could be detected at the earlier period of coronary disease, suggesting its importance for the prevention and treatment in coronary disease. Pro - BNP could reflect the severity of myocardial damage, and could be a predictive indicator of the onset of cardiovascular diseases. Conclusion Changes of Mb, CK - MB, cTnI, Hcy, and pro - BNP levels in the different stages of myocardial damage and before and after treatment suggest these biomarkers participate in the development of the disease and closely relate to the efficacy of treatment. The simultaneous detection of these biomarkers can increase diagnostic value of the biomarkers.