血清Mb、cTnT、Hcy、hs-CRP水平联合检测对急性心肌梗死早期诊断的临床价值分析

Study of Combined Detection of Serum Myoglobin,Cardiac Troponin T,Homocysteine and Hypersensitive C-Reaction Protein in Early Clinical Diagnosis of Acute Myocardial Infarction

目的探讨联合检测血清肌红蛋白(Myoglobin,Mb)、心肌肌钙蛋白T(cardiac troponin T,cTnT)、同型半胱氨酸(homocysteine,Hcy)、超敏C反应蛋白(hypersensitive C-reaction protein,hs-CRP)水平对急性心肌梗死(acute myocardial infarction,AMI)早期诊断的临床应用价值。方法应用化学发光法和免疫比浊法对71例AMI患者、63例不稳定性心绞痛(unstable angina pectoris,UAP)患者、58例稳定性心绞痛(stable angina pectoris,SAP)患者和50名健康体检者进行血清Mb、cTnT、Hcy和hs-CRP水平测定,数据经统计学处理。结果 AMI、UAP、SAP三组患者血清Mb、c Tn T、Hcy和hs-CRP水平显著高于对照组(P <0. 01),且四项指标升高与AMI呈正相关(r=0. 972、0. 998、0. 761、0. 516); Mb、cTnT、Hcy和hs-CRP单项指标检测对AMI的阳性检出率分别为95.2%、94.4%、62.0%、94.4%,与对照组比较差异非常显著(P <0. 001);四项指标联合检测,灵敏度、特异性均达100%,且灵敏度与特异性之和最大。结论血清Mb、c Tn T、Hcy和hs-CRP水平变化与AMI密切相关,联合检测以上四项血清指标对AMI的早期诊断和治疗具有非常重要的临床价值。

Objective The purpose of this study was to investigate the clinical application value of combined detection of serum Myoglobin（Mb）,cardiac troponin T（cTnT）,Homocysteine（Hcy）and Hypersensitive C-reaction protein（hs-CRP）in early clinical diagnosis of acute myocardial infarction（AMI）. Methods The serum Mb,cTnT,Hcy and hs-CRP concentrations of 71 cases with AMI,63 cases with unstable angina pectoris（UAP）,58 cases with stable angina pectoris（SAP）,and 50 healthy individuals were detected by using chemiluminescence and immunoturdimetry assay.The data were analyzed by SPSS12.0. Results Detection result showed that the serum Mb,cTnT,Hcy and hs-CRP concentrations of AMI,UAP and SAP group were significantly higher than those of the healthy group（ P 〈0.01）.Further statistical analysis reveal that there was a positive correlation between the increased four markers（Mb,cTnT,Hcy and hs-CRP）and AMI（r=0.972,0.998,0.761,0.516）with sensitivity of 95.2%,94.4%,62.0% and 94.4%,respectively,which exhibit significant difference from that of the healthy group（ P 〈0.001）.Moreover,combined detection of serum Mb,cTnT,Hcy and hs-CRP would increase both sensitivity and specificity to 100%. Conclusions The increased serum Mb,cTnT,Hcy and hs-CRP concentration are closely related to AMI.Consequently,combined detection of serum Mb,cTnT,Hcy and hs-CRP have important clinical value for AMI early clinical diagnosis and treatment.