cTnI cTnT、CM-MB对急性心肌梗死的早期诊断价值分析

Value of cTnI,cTnT and CM-MB in the early diagnosis of acute myocardial infarction

目的:分析急性心肌梗死(acute myocardial infarction,AMI)患者肌钙蛋白I(cardiac troponin I,cTnI)、肌钙蛋白T(cardiac troponin T,cTnT)及肌酸激酶同工酶(creatine kinase MB,CM—MB)表达水平并分析各指标单独及联合应用时对AMI早期诊断价值。方法:选取2017年10月〜2019年10月我院因持续胸骨前疼痛入院的194例患者并采集外周静脉血检测血清cTnI、cTnT及CM-MB水平,然后以临床诊断结果为金标准作受试者工作特征曲线(receiver operator characteristic,ROC)曲线分析各指标诊断价值。结果:194例患者中最终确诊124例AMI(63.92%),AMI组血清cTnI、cTnT及CM-MB水平高于非AMI组,差异有统计学意义(P<0.05);cTnI、cTnT及CM-MB诊断AMI的曲线下面积(areaunder curve,AUC)分别为0.840、0.820和0.757,灵敏度分别为76.61%、66.13%和51.61%,特异度分别为94.29%、91.43%和92.86%,联合各指标对AMI进行诊断的AUC为0.923,灵敏度和特异度分别为83.06%和97.14%。结论:血清cTnI、cTnT及CM-MB水平在AMI早期诊断中均具有良好参考价值,联合检测可进一步提升诊断准确率,为及时进行合理治疗提供参考依据。

Objective:To analyze the expression levels of troponin I(cTnl),troponin T(cTnT)and creatine kinase isoenzyme(CM-MB)in patients with acute myocardial infarction(AMI),and to evaluate the value of individual and combined application of the indicators in the early diagnosis of AMI.Methods:A total of 194 patients admitted to our hospital for persistent presternal pain from October 2017 to October 2019 were selected.Peripheral venous blood was collected to detect the levels of serum cTnI,cTnT and CM-MB.ROC curves were made using the clinical diagnosis results as the gold standard to analyze the diagnostic value of each indicator.Results:Among the 194 patients,124 AMI cases(63.92%)were finally diagnosed.The levels of serum cTnI,cTnT and CM-MB in AMI group were higher than those in non-AMI group(P<0.05).The AUC values of cTnI,cTnT and CM-MB in diagnosing AMI were 0.840,0.820 and 0.757 respectively,and the sensitivities were 76.61%,66.13%and 51.61%respectively,and the specificities were 94.29%,91.43%and 92.83%.The AUC value of combined application of the indicators was 0.923 in the diagnosis of AMI,and the sensitivity and specificity were 83.06%and 97.14%respectively.ConClusion:Serum cTnI,cTnT and CM-MB levels have good reference value in the early diagnosis of AMI.Combined detection can further improve the diagnostic accuracy rate and provide a reference for timely and reasonable treatment.