常用急性心肌梗死诊断标志物临床应用价值比较

A COMPARISON OF CARDIAC MARKERS IN THE DIAGNOSIS OF ACUTE MYOCARDIAL INFARCTION

①目的 比较几种常用的急性心肌梗死 (AMI)诊断标志物的临床应用价值。②方法 检测 46例AMI病人及 62例心绞痛 (AP)病人血清中的心肌肌钙蛋白Ⅰ (cTnⅠ )、肌红蛋白 (Mb)、肌酸激酶 (CK)、肌酸激酶同工酶 (CK MB)含量 ,并进行对比分析。③结果 AMI组cTnⅠ、Mb、CK、CK MB各指标阳性率分别为 93 .48%、97.83 %、65 .2 2 %、76 .0 9% ;AP组各指标阳性率分别为 1 .68%、48.39%、32 .2 6 %、1 4 .52 %。Mb与cTnⅠ对AMI诊断灵敏度差异无显著性 (χ2 =0 .345 ,P >0 .0 5) ;两者高于CK、CK MB对AMI诊断灵敏度 (χ2 =4.1 2 8～ 9.552 ,P <0 .0 1、0 .0 5)。cTnⅠ与CK MB对AMI诊断特异度分别为 90 .32 %、85 .48% ,两者比较差异无显著意义 (χ2 =0 .683 ,P >0 .0 5) ;两者高于Mb与CK对AMI诊断特异度 (χ2 =9.538～ 2 2 .545 ,P <0 .0 1 )。

Objective\ To compare the clinical diagnostic value of cardiac markers for diagnosing acute myocardial infarction(AMI). \ Methods\ The serum troponin (cTn Ⅰ ), myoglobin(Mb), creatine kinase (CK), creatine kinase MB(CK MB) levels were simultaneously measured in 46 patients with AMI and 62 patients with angina pectoris (AP).\ Results\ In AMI group, the positive rates of cTn Ⅰ, Mb, CK, CK MB were 93.48%, 97.83%, 65.22% and 76.09%, respectively. In AP group, the rates of the above items were 1.68%, 48.39%, 32.26% and 14.52%, respectively. The difference of the sensitivity of cTn Ⅰ and Mb was not significant in the diagnosis of AMI ( χ 2=0.345, P >0.05),which were significantly higher than those of CK,CK MB ( χ 2=4.128-9.552,P <0.01, 0.05). The specificity of cTn Ⅰ and CK MB was 90.32% and 85.48%, respectively, for diagnosing AMI, the difference between them was not significant ( χ 2=0.683, P >0.05). The diagnostic specificity of cTn Ⅰ and CK MB was higher than those of Mb and CK in the diagnosis of AMI ( χ 2=9.538-22.545,P <0.01).\ Conclusion\ cTn Ⅰ is a better marker for diagnosing AMI.