血清肌钙蛋白I与肌酸激酶同工酶对急性心肌梗死的诊断价值

Diagnostic value of serum troponin I and creatine kinase isoenzyme on acute myocardial infarction

目的探讨血清肌钙蛋白I(cTnI)与肌酸激酶同工酶(CK-MB)对急性心肌梗死(AMI)的诊断价值。方法选择2011年1月～2012年1月在本院住院的AMI患者100例为研究对象,应用免疫化学发光法检测cTnI含量,全自动生化分析仪检测CK-MB。对符合溶栓条件的36例患者行溶栓治疗。结果 cTnI升高时间在溶栓组患者中与CK-MB相当(P>0.05),在未溶栓组则迟于CK-MB出现(P<0.05);溶栓再通组患者的cTnI与CK-MB达到高峰的时间均早于溶栓未通组和未溶栓组(P<0.05),而每组患者的cTnI和CK-MB间差异则无统计学意义(P>0.05);各组患者cTnI持续时间明显长于CK-MB(P<0.05)。cTnI的敏感性和特异性均高于CK-MB。结论血清cTnI和CK-MB的联合检测对诊断AMI有重要意义,cTnI是一种优于CK-MB的辅助诊断AMI的特异性血清标志物。

Objective To investigate the diagnostic value of serum troponin I （cTnI） and creatine kinase isoenzyme （CK-MB） on acute myocardial infarction （AMI）. Methods One hundred cases of AMI patients in our hospital were selected from January 2011 to January 2012 for the study, immuno-chemiluminescence was used to detect cTnI, automatic biochemical analyzer was used to detect CK-MB. 36 patients comply with thrombolytic conditions were underwent thrombolytic treatment. Results The increased time of cTnI was correspond to CK-MB in thrombolysis group （P 0.05）, but it was later than CK-MB in non-thrombolysis group （P 0.05）; cTnI and CK-MB peaked time in thrombolytic recanalization group was earlier than that of thrombolysis did not pass group and non-thrombolysis group （P 0.05）, and in each group there was no statistically significant difference between cTnI and CK-MB （P 0.05）. Duration time of cTnI was significantly longer than CK-MB in each group （P 0.05）. The sensitivity and specificity of cTnI were higher than CK-MB. Conclusion The combined detection of serum cTnI and CK-MB have great significance in the diagnosis of AMI, cTnI is a specific serum marker which is better than CK-MB in secondary diagnosis of AMI.