血栓前体蛋白和心肌肌钙蛋白Ⅰ联合检测在急性冠状动脉综合征诊断中的临床价值

Thrombus Precursor Protein and Cardiac Troponin Ⅰ in the Diagnosis of the Clinical Value of Combined Detection of Integrated Acute Coronary Artery Syndrome

目的探讨血栓前体蛋白（Tp P）和心肌肌钙蛋白I（c Tn I）联合检测在急性冠状动脉综合征（ACS）诊断中的临床价值。方法将我院2014-01～2015-03间72例急性冠状动脉综合征患者,根据疾病类型分为两组,40例不稳定型心绞痛（UAP）患者为UAP组,32例急性心肌梗死（AMI）患者为AMI组。对两组患者胸痛发作后6 h内、24 h Tp P、c Tn I浓度进行比较,并观察两组患者在胸痛6 h时Tp P、c Tn I及磷酸肌酸激酶同工酶（CK-MB）异常发生率。结果 AMI组患者胸痛6 h内Tp P、c Tn I浓度明显高于UAP组（P〈0.05）;24 h两组Tp P、c Tn I浓度比较差异无显著性（P〉0.05）。胸痛6 h内UAP组Tp P、c Tn I与CK-MB阳性率分别为7.5%、100%、2.5%;AMI组分别为100%、100%、6.3%;AMI组Tp P阳性率明显高于UAP组（P〈0.05）。结论 Tp P、c Tn I检测方便,周期短,前者对急性血栓形成有较高的特异性,后者具有高度的心肌特异性,有助于早期鉴别诊断和治疗,具有较高的临床应用价值。

Objective To explore the clinical value of thrombus precursor protein（ Tp P） and cardiac troponin I（ c Tn I） joint detection in the diagnosis of acute coronary syndrome（ ACS）. Methods 72 cases of patients with acute coronary syndrome in the hospital from January,2014 to March,2015 were divided into two groups according to the type of disease,40 patients with unstable angina pectoris（ UAP）patients were as group UAP,and 32 patients with acute myocardial infarction（ AMI） patients as AMI group. The onset of chest pain after6 h,24h Tp P,c Tn I concentrations were compared,and chest pain in 6h Tp P,c Tn I and creatine kinase isoenzyme（ CK- MB） abnormal rates of the two groups were observed. Results In AMI group,6h Tp P in patients with chest pain in the concentration of c Tn I was higher than that in group UAP（ P〈0. 05）; there was no significant difference of 24 h the concentration of Tp P and c Tn I（ P〈0. 05）. Tp P,c Tn I and CK- MB positive rates 6h chest pain in group UAP were 7. 5%,100% and 2. 5%; and those in AMI group were 100%,100% and6. 3%; the positive rate of Tp P in AMI group was significantly higher than group UAP（ P〈0. 05）. Conclusion Tp P and c Tn I detection is convenient,the cycle is short,the former have high specificity for acute thrombosis,the latter has a height of muscle specific,and is helpful in the early differential diagnosis and treatment,which has significant clinical value.