血清高敏心肌肌钙蛋白T对急性心肌梗死早期诊断的价值

Level of serum high-sensitivity cardiac troponin T and early diagnosis of acute myocardial infarction

目的探讨血清高敏心肌肌钙蛋白T(hs-cTnT)对于急性心肌梗死(AMI)早期诊断的价值。方法选取2016年3月~2017年3月于德阳市第二人民医院确诊的80例AMI患者纳入AMI组,发病6 h内入院;40例心内科确诊的慢性心力衰竭(CHF)患者纳入CHF组;40例健康体检者纳入对照组。检测3组血清hs-cTnT、肌红蛋白(Myo)、心肌肌钙蛋白T(cTnT)、肌酸激酶同工酶(CK-MB)水平。分析hs-cTnT诊断AMI的价值。结果 AMI组的血清hs-cTnT、Myo、cTnT、CK-MB水平均显著高于CHF组和对照组,差异均具有统计学意义(P均<0.05)。AMI组患者的血清hs-cTnT与Myo、cTnT、CK-MB均呈显著的正相关,相关系数分别为0.479、0.714、0.520(P均<0.05)。发病6 h内检测AMI患者的血清hscTnT水平,绘制受试者工作特征曲线(ROC),hs-cTnT取0.050 ng/mL时为最佳临界值,此时灵敏度为98.96%、特异度为97.33%、漏诊率为1.04%、误诊率为2.67%、ROC曲线下面积(AUC)值为0.969。结论hs-cTnT诊断早期AMI具有较高的灵敏度与特异度。

Objective To investigate the value of level of serum high-sensitivity cardiac troponin T(hs-cTnT)to the early diagnosis of acute myocardial infarction(AMI).Methods AMI patients(n=80)were chosen into AMIgroup(hospitalized within6h after AMI onset),and patients with chronic heart failure(CHF,n=40)were choseninto CHF group,and health controls(n=40)were chosen into control group from the Second Hospital of DeyangCity from Mar.2016to Mar.2017.The levels of serum hs-cTnT,myoglobin(MYO),cardiac troponin T(cTnT)andcreatine kinase-M B isoenzyme(CK-MB)were detected in3groups.The value of hs-cTnT to AMI diagnosis wasanalyzed.Results The levels of serum hs-cTnT,MYO,cTnT and CK-MB were significantly higher in AMI groupthan those in CHF and control group(all P<0.05).The level of serum hs-cTnT was significantly correlated to MYO,cTnT and CK-MB(r=0.479,0.714,0.520,all P<0.05).The level of serum hs-cTnT was detected within6h afterAMI onset and receiver operating characteristic curve(ROC)was drawn.When the best critical value of serum hscTnTwas0.050ng/mL,the sensitivity was98.96%,specificity was97.33%,omission diagnostic rate was1.04%,the misdiagnosis rate was2.67%,and area under curve(AUC)of ROC was0.969.Conclusion hs-cTnT has highersensitivity and specificity in early diagnosis of AMI.