肌钙蛋白、肌红蛋白和肌酸激酶同工酶联合检测对早期急性心肌梗死的诊断价值和预后效应

Diagnostic value and prognostic effect of combined detection of troponin,myoglobin and creatine kinase isozymes in early acute myocardial infarction

【目的】分析早期急性心肌梗死(AMI)患者血清心肌肌钙蛋白Ⅰ(cTnⅠ)、肌红蛋白(Mb)及肌酸激酶同工酶(CK-MB)水平变化与病情严重程度及预后的相关性。【方法】选取于本院就诊的86例AMI患者进行研究,为观察组,另选取同期90例健康人群作为对照组。分析血清cTnⅠ、Mb、CK-MB水平变化与AMI患者病情严重程度及预后的关系;采用受试者工作特征(ROC)曲线分析其对早期AMI的临床预测价值;采用Cox回归模型行预后因素分析。【结果】观察组血清cTnⅠ、Mb、CK-MB水平明显高于对照组,且随着Killip分级增高其水平逐级升高(P<0.05)。预后不良组AMI患者血清cTnⅠ、Mb、CK-MB水平明显高于预后良好组(P<0.05)。血清cTnⅠ、Mb、CK-MB联合诊断AMI的曲线下面积为0.889,诊断灵敏度及特异度明显高于任意单个指标诊断。血清cTnⅠ、Mb、CK-MB水平升高是AMI预后不良的独立危险因素。【结论】早期AMI患者血清cTnⅠ、Mb、CK-MB水平明显升高,与病情严重程度及预后关系密切;三者联合检测诊断AMI的价值较高,对AMI的早期识别诊断具有重要意义。

【Objective】To analyze the correlation between the changes of serum cardiac troponinⅠ(cTnⅠ),myoglobin(MB)and creatine kinase isoenzyme(CK-MB)levels and the severity and prognosis of patients with early acute myocardial infarction(AMI).【Methods】A total of 86 patients with AMI in our hospital were selected for study,and 90 healthy people in the same period were selected as control.The relationship between the changes of serum cTnⅠ,MB and CK-MB levels and the severity and prognosis of AMI patients was analyzed;Receiver operating characteristic curve(ROC curve)was used to analyze its clinical predictive value for early AMI;Cox regression model was used to analyze the prognostic factors.【Results】The levels of serum cTnⅠ,MB and CK-MB in the observation group were significantly higher than those in the control group,and their levels increased step by step with the increase of Killip grade(P<0.05).The levels of serum cTnⅠ,MB and CK-MB in patients with AMI in poor prognosis group were significantly higher than those in good prognosis group(P<0.05).The area under the curve of serum cTnⅠ,MB and CK-MB in the combined diagnosis of AMI was 0.889.The diagnostic sensitivity and specificity were significantly higher than those of any single index.The elevated levels of serum cTnⅠ,MB and CK-MB are independent risk factors for poor prognosis of AMI.【Conclusion】The levels of serum cTnⅠ,MB and CK-MB in patients with early AMI were significantly increased,which was closely related to the severity and prognosis of the disease;The combined detection of the three has high diagnostic value for AMI,which is of great significance for the early identification and diagnosis of AMI.