cTn-I、Mb、CK-MB对急性心肌梗死快速诊断的价值

The clinical value of cTn- I,Mb,CK- MB rapid diagnosis of acute myocardial infarction

目的：探讨cTn-Ⅰ、Mb和CK-MB检验在急性心肌梗死患者中的临床诊断意义.方法：对35例本院确诊为急性心梗患者做回顾性调查分析,依据入院时间比较其CTn-Ⅰ、Mb、CK-MB的阳性率及阴性率,以及在各时段用CTn-Ⅰ、Mb、CK-MB诊断AMI的敏感性及特异性进行比较.结果：在AMI早期诊断中,Mb的灵敏度最高,而CK-MB在8h以内的结果与正常组比较没有统计学意义.cTn-Ⅰ的早期诊断价值良好.单项检测时CK-MB的特异性在AMI早期诊断中的价值有限.当多项目联合检测时,真阳性率有较大提高,可得到较满意的结果,加上连续动态检测,可以基本排除AMI漏检的可能性.Mb＋ cTn-Ⅰ组合的真阳性率,在4 ～8h已达到100％的满意效果,与Mb＋ cTn-Ⅰ＋CK-MB组相同.结论：在AMI的急诊患者及时做CK-MB、Mb、CTn-Ⅰ的检查及动态观察能提高确诊率（确定是AMI或非AMI）,可以为患者接受及时正确的治疗保障时间.

Objective： To investigate the cTn -Ⅰ, Mb and CK- MB test in patients with acute myocardial infarction clinical diagnosis. Method： 35 patients diagnosed with acute myocardial infarction hospital doing retrospective analysis, according to the admission time to compare their CTn - Ⅰ, Mb, CK - MB - positive rate and negative rate, as well as in each period with CTn - I, Mb, CK AMI - MB diagnostic sensitivity and specificity were compared. Results： Early diagnosis of AMI, Mb highest sensitivity, while CK - MB resuhs within 8 hours compared with the normal group was not statistically significant, cTn - Ⅰ value of early diagnosis is good. Individual detection specificity of CK - MB in the early diagnosis of AMI limited value. When the multi - project joint detection, the true positive rate has improved greatly, satisfactory results can be obtained, together with a continuous motion detection, you can basically rule out the possibility of missed AMI. Mb ＋ cTn - Ⅰ combination of true - positive rate of 4 to 8 hours has reached 100% satisfied with the results, and Mb ＋ cTn - Ⅰ ＋ CK - MB same set. Conclusions： AMI patients in the emergency department time to do CK - MB, Mb, CTn -I examination and dynamic observation can improve the diagnosis rate （determined to be AMI or AMI）, patients can guarantee timely and correct treatment time.