高敏肌钙蛋白Ⅰ、肌钙蛋白Ⅰ联合心肌标志物对微小心肌损伤的早期诊断价值

Early diagnostic value of hs-cTnⅠ and cTnⅠ combined with myocardial markers in minor myocardial damage

目的研究高敏肌钙蛋白Ⅰ(hs-cTnⅠ)、肌钙蛋白Ⅰ(cTnⅠ)联合常规心肌标志物在微小心肌损伤(MMD)早期诊断中的应用价值。方法测定172例胸痛患者血清hs-cTnⅠ、cTnⅠ及肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、肌红蛋白(Mb)、超敏C反应蛋白(hs-CRP)等常规心肌标志物的水平。MMD组中包括不稳定型心绞痛(UA)68例、非ST段抬高心肌梗死(NSTEMI)45例,ST段抬高心肌梗死(STEMI)34例。另选取80例健康体检者作为对照组。结果观察组早期血清各项指标水平及阳性率均明显高于对照组,差异有统计学意义(P<0.05)。hs-cTnI联合4项指标检测阳性率为99.4%,高于cTnI的阳性率94.8%,差异有统计学意义(P<0.05)。MMD组患者各项指标水平均高于非缺血性胸痛(NICP)组和对照组,差异有统计学意义(P<0.05)。STEMI组患者各项指标水平最高。结论早期诊断MMD中,血清hs-cTnI比cTnI更敏感,多项指标联合检测有重要临床意义。

ObjectiveTo analyze the application value of serum hyper sensitivity cardiac troponin I（hs cTnI）and cTnI combined with routine myocardial markers in early diagnosis of minor myocardial damage（MMD）.MethodsThe level of serum routine myocardial markers such as hs cTnI,cTnI,CK,CK MB,hs CRP and Mb in 172 cases of chest pain patients were detected,including 68 cases of unstable angina（UA）,45 cases of non ST segment elevation myocardial infarction（NSTEMI）and 34 cases of STEMI.Other 80 individuals undergoing health physical examination were selected as the control group.ResultsThe levels of serum various indicators and positive rates in the observation group were significantly higher than those in the control group,the difference was statistically significant（P〈0.05）.The detection positive rate of hs cTnI combined with 4 indicators detection was 99.4%,which was higher than 94.8% of cTnI,the difference was statistically significant（P〈0.05）.The levels of various indicators in the MMD were higher than those in the non eschemic chest pain（NICP）group and control groups,the differences were statistically significant（P〈0.05）.The levels of various indictors in the STEMI group were highest.ConclusionSerum hs cTnI is more sensitive than cTnI for early diagnosis of MMD.The joint detection of multiple indicators has an important clinical significance.