肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、肌红蛋白(Mb)浓度监测在诊断急性心肌梗死(AMI)中的作用

The Role of Monitoring Concentration of Troponin I (cTnI), Creatine Kinase Isoenzyme MB(CK-MB), Myoglobin (Mb) on The Diagnosis of Acute Myocardial Infarction (AMI)

目的研究肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、肌红蛋白(Mb)浓度监测在诊断急性心肌梗死(AMI)中的作用。方法采用电化学发光法检测45例急性心肌梗死患者在胸痛发作后五个时间点的cTnI、CK-MB以及Mb血清浓度,以45例健康体检者作为对照,并对上述数据进行统计学分析,研究其诊断价值。结果 AMI患者在胸痛发作后所有检查时间内的血清cTnI、CK-MB浓度均高于对照组,差异有显著意义,血清Mb浓度在患者胸痛发作后0-6h、12h、24h均高于对照组,而且在诊断急性心肌梗死的特异度、灵敏度、准确度、阳性预测值和阴性预测值方面,cTnI和CK-MB均明显高于Mb。结论同时检测cTnI和CK-MB两个血清标记物,对于早期诊断AMI具有重要意义,有助于改善患者预后。

Objective Investigate the role of monitoring serum concentration of cardiac troponin I （cTnI）, creative kinase isoenzyme MB （CK-MB） and myoglobin （Mb） on the diagnosis of Acute Myocardial Infarction （AMI）.Methods Detect serum concentration of cTnI, CK-MB and Mb from 45 cases of AMI patients using electrochemical luminescence at five different timepoints. And another 45 cases of healthy controls were examined. Analyze cTnI, CK- MB and Mb concentration by variance analysis and ROC curve, and discuss the diagnostic value .Results The serum concentrations of cTnI, CK-MB in AMI patients were significantly higher than control at all 5 different timepoints after onset of chest pain. The serum concentration of Mb in AMI patients was significantly higher than control at 0-6h, 12h, 24h after chest pain. And specificity, sensitivity, accuracy, positive predictive value （PPV） and negative predictive value （NPV） of cTnI, CK-MB were significantly higher than Mb on the diagnosis of AMI. Conclusion Combined detecting serum concentration dynamie changes of cTnI and CK-MB had significant value and high accuracy on early diagnosis of AMI, which help to improve the prognosis of patients.