急性心肌梗死患者血清肌红蛋白 肌钙蛋白以及超敏C-反应蛋白含量动态监测的临床意义

The clinical significance of serum myoglobin,troponin and high sensitivity C-reactive protein levels in the dynamic monitoring of patients with acute myocardial infarction

目的分析并评价联合检测肌钙蛋白Ⅰ(cTnI)、肌红蛋白(Myo)以及超敏C反应蛋白(hs-CRP)对急性心肌梗死(AMI)诊断的临床应用价值。方法将2010年10月至2011年10月期间收治的42例急性心肌梗死患者作为治疗组,选择同期体检的健康人员42例为对照组,对比分析两组受检人员的cTnI、Myo以及hs-CRP的血清水平。结果治疗组的Myo、hs-CRP以及cTnI 3个指标的浓度高于对照组,两组比较差异具有统计学意义(P<0.05)。治疗组Myo指标在急性心肌梗死发生后0～4 h出现上升,8～12 h达峰值,12～24 h后出现回落,3 d后降至正常值;cTnI指标在急性心肌梗死发生后4～8 h出现上升,8～12 h达峰值,12～24 h始终处于高水平,3 d后出现回落;hs-CRP在急性心肌梗死发生后逐步上升,2～24 h达高峰,3 d后回落至正常值。结论采用Myo、cTnI以及hs-CRP检测急性心肌梗死各具优势,联用3个指标进行检测能够将各自优势进行互补,在早期诊断急性心肌梗死方面具有较好的应用价值,提倡在临床上推广应用。

Objective To analyze and evaluate the clinical value of the combination of troponin I（cTnI）,myoglobin（Myo,） and high sensitivity C-reactive protein（hs-CRP） in the diagnosis of acute myocardial infarction（AMI）.Methods A total of 42 patients with acute myocardial infarction admitted to the hospital from October 2010 to October 2011 were chosen as the treatment group and 42 cases of healthy staff who underwent earlier physical examination in the hospital were chosen as control group.cTnI,Myo,and hs-CRP serum levels of the subjects in the two groups were compared and analysed.Results Myo,hs-CRP and three indicators of cTnI concentration of the treatment group were higher than those of the control,and the difference between the two groups was statistically significant（P0.05）.The Myo indicators of the treatment group patients rose 0~4h after acute myocardial infarction,reached the peak in 8 to 12 h,fell after 12~24 hours,and fell to normal 3 days later;cTnI indicators rose 4~ 8 h after acute myocardial infarction,reached its peak in 8~12 h,was always at a high level during 12 to 24 h,and fell on 3d;hs-CRP gradually increased,reached a peak 2~24 h after the occurrence of acute myocardial infarction,and fell back to normal after 3d.Conclusion Myo,cTnI and hs-CRP testing in patients with acute myocardial infarction has their own advantages.The combination of the three indicators can complement each other in their respective advantages and may achieve the desired value in the early diagnosis of acute myocardial infarction,which is worth the clinical promotion and application.