凝血酶原时间、活化部分凝血活酶时间、纤维蛋白原、凝血酶时间、心肌指标检测在冠心病诊断中的意义

Significance of detection of PT,APTT,TT,Fib and myocardial indexes in diagnosis of coronary heart disease

目的:探析凝血功能凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fib)与心肌标志物心肌肌钙蛋白I(CTnI)、肌红蛋白(Myo)、超敏C反应蛋白(hs-CRP)、肌酸激酶同工酶(CK-MB)诊断冠心病的应用价值。方法:选取120例稳定型心绞痛(SA)、不稳定型心绞痛(UA)和急性心肌梗死(AMI)各40例冠心病患者与60例健康志愿者进行回顾性分析,检测四组研究对象的CTnI、Myo、hs-CRP、CK-MB、PT、APTT、TT、Fib各指标。结果:AMI组、UA组、SA组和健康对照组CTnI、Myo、CK-MB及hs-CRP水平对比,差异具有统计学意义(均P<0.05)。其中AMI组的Myo、CK-MB及hs-CRP水平均高于UA组、SA组和健康对照组,UA组高于SA组和健康对照组,SA组高于健康对照组,差异具有统计学意义(均P<0.05)。AMI组的PT、APTT、TT值均低于UA组、SA组及健康组,而Fib高于UA组、SA组及健康组,差异具有统计学意义(均P<0.05)。UA组PT、APTT、TT值均低于UA组、SA组及健康组,而Fib高于SA组及健康组,差异具有统计学意义(均P<0.05)。SA组的PT、APTT、TT及Fib水平与健康对照组比较,差异无统计学意义(均P>0.05)。结论:冠心病患者心肌标志物与凝血功能指标参与患者病变过程,可联合应用于诊断冠心病。

Objective:To explore the diagnostic value of prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(Fib) and myocardial markers cardiac troponin I(CTnI),myoglobin(Myo),hypersensitive C-reactive protein(hs-CRP) and creatine kinase isoenzyme(CK-MB) in the diagnosis of coronary heart disease.Methods:A total of 120 coronary heart disease patients [including 40 cases stable angina(SA),40 cases unstable angina(UA) and 40 cases acute myocardial infarction(AMI)]and 60 healthy volunteers were retrospectively analyzed.CTnI,Myo,hs-CRP,CK-MB,PT,APTT,TT and Fib of the four groups were detected.Results:The levels of CTnI,Myo,CK-MB and hs-CRP in four groups were significantly different(all P<0.05).The levels of Myo,CK-MB and hs-CRP in AMI group were higher than those in UA group,SA group and healthy control group,and those in UA group was higher than those in SA group and healthy control group,and those in SA group was higher than those in healthy control group(all P<0.05).The values of PT,APTT and TT in AMI group were lower than those in another three groups,while Fib was higher than those in another three groups(all P<0.05).The values of PT,APTT and TT in UA group were lower than those in another three groups,while Fib was higher than those in SA group and healthy group(all P<0.05).The levels of PT,APTT,TT and Fib in SA group were not significantly different from those in healthy control group(all P>0.05).Conclusion:Myocardial markers and coagulation indexes in patients with coronary heart disease participate in the process of the disease,can be combined in the diagnosis of coronary heart disease,with high clinical value.