急性胸痛患者联合检测cTn-I、CK-MBmass和Myo的临床价值

The clinical value of cTn-1,CK-MBmass and Myo in diagnosis of acute chest pain

目的 了解急性胸痛患者胸痛发作初期时血液中心肌钙蛋白 -Ｉ（ｃＴｎ -Ｉ）、肌酸激酶同工酶（ＣＫ-ＭＢｍａｓｓ）和肌红蛋白（Ｍｙｏ）浓度的动态变化 ,探讨３项指标联合检测用于心肌梗死（ＡＭＩ）早期诊断的临床价值。方法 于患者胸痛发生的１～２ｈ、３～４ｈ、５～６ｈ,分别采血 ,用荧光免疫干片法同时定量检测ｃＴｎ-Ｉ、ＣＫ -ＭＢ ｍａｓｓ、Ｍｙｏ值。结果 ４２例急性胸痛患者最终确诊为ＡＭＩ２５例 ,其３～４ｈ、５～６ｈｃＴｎ-Ｉ、ＣＫ -ＭＢｍａｓｓ和Ｍｙｏ的测定值较非ＡＭＩ患者均明显升高（Ｐ＜０．０５或０．０１） ;ＡＭＩ患者３～４ｈ、５～６ｈｃＴｎ-Ｉ的阳性率较非ＡＭＩ患者显著升高(Ｐ＜０．０１) ,１～２ｈ、３～４ｈ、５～６ｈＣＫ-ＭＢｍａｓｓ和Ｍｙｏ的阳性率均较非ＡＭＩ患者显著升高 (Ｐ＜０．０５或０．０１)。结论用荧光免疫干片法联合检测急性胸痛患者血中ｃＴｎ-Ｉ、ＣＫ -ＭＢｍａｓｓ、Ｍｙｏ浓度快速、简便 ,所得结果特异、敏感、稳定 ,有助于快速诊断ＡＭＩ,为临床及时有效治疗ＡＭＩ、降低死亡率创造条件。

Objective To observe the levels of cTn-1,CK-MBmass and Myo in patients with acute chest pain and to explore their role in diagnosis of acute myocardiac infarction (AMI). Methods Heparinized whole blood samples were drawn from patients with chest pain within 1～2h, 3～4h, 5～6h after attack. Fluorescent immunoassay was used for the quantitative determination of cTn-1, CK-MBmass and Myo respectively. Results The levels of cTn-1, CK-MBmass and Myo in patients with AMI within 3～4h, 5～6h was significantly higher than those of normal subjects (P<0.05 or 0.01),the positive rate of cTn-1 within 3～4h, 5～6h was significantly elevated in the patients with AMI compared with normal subjects (P<0.01), and the positive rate of CK-MBmass,Myo within 1～2h,3～4h,5～6h was significantly higher than those of normal subjects (P<0.05 or 0.01).Conclusion The study suggests that the combined tests of cTn-1,CK-MBmass and Myo with fluorescent immunoassay is useful for early diagnosis of AMI.