三种心肌损伤标志物在急性心肌梗死早期诊断中的应用价值

Value of three cardiac markers in the early diagnosis of acute myocardial infarction

目的:比较三种心肌损伤标志物在急性心肌梗死早期诊断中的应用价值。方法:选取本院的急性心肌梗死患者90例,设为实验组,按发病时间分为0~3 h组34例和3~6 h组56例。另选取肌肉损伤患者20例,80例健康体检者作为对照组。同时测定血清心型脂肪酸结合蛋白(heart fatty acid-binding protein,H-FABP)、高敏肌钙蛋白(high-sensitivity cardiac troponin I,hs-c Tn I)、肌钙蛋白(cardiac troponin I,c Tn I)和肌红蛋白(myoglobin,MYO)的浓度。结果:0~3 h组和3~6 h组患者血清H-FABP、hs-c Tn I和MYO的浓度均高于对照组(P<0.01);肌肉损伤患者血清MYO浓度高于对照组(P<0.01);在AMI发病的最初0~3 h和3~6 h内,H-FABP和hs-c Tn I的特异性及敏感性均高于MYO;在AMI发病的早期hs-c Tn I较c Tn I敏感度高。结论:H-FABP和hsc Tn I可作为AMI早期诊断的良好血清标志物。

AIM： To explore the value of three cardiac markers in the early diagnosis of acute myo- cardial infarction （AMI）. METHODS ： 90 cases of AMI were selected as the experimental group, and were further divided into the （0-3 h） group （34 ca- ses） and （3-6 h） group （56 cases） according to the on-set time. 80 cases of healthy check-ups were re- cruited in the control group, and another 20 cases of muscle injury were also selected in this experiment. High-sensitivity cardiac troponin ] （hs-cTnI） , heart fatty acid-binding protein （H-FABP） and myoglobin （ MYO ） were measured simultaneously. RE- SULTS ： Serum concentrations of HFABP, hs-cTnI and MYO in the 34 AMI patients of （0-3 h） group and 56 AMI patients level of the experimental group were higher than those of control group（P 〈 0. 01 ） ; serum concentrations of MYO in patients with muscle injury were higher than those of control group （P 〈 0.01 ）; the specificity and sensitivity of H-FABP and cTnI were higher than those of MYO within the early onset time of AMI （0-3 h, 345 h）; hs-eTnI was more sensitive than cTnI in the early onset of AMI. CONCLUSION： H-FABP and hs-eTnI can be referential serum markers for early diagnosis of AMI.