心肌肌钙蛋白I、肌红蛋白检测在急性心肌梗塞中的诊断价值

The dictective value of serum troponin and myoglobin in the patients with acute myocardial infarction.

目的探讨CTnI、Mb对急性心肌梗塞(AMI)早期诊断的价值。方法对26例AMI患者、41例不稳定性心绞痛(UAP)患者、30例骨骼肌损伤(SM)患者和30例健康者进行血清CTnI、Mb、CK-MB的测定,并对AMI患者胸痛发生不同时段进行动态检测。结果AMI患者入院时CTnI、Mb、CK-MB的阳性检出率分别是65.4%、73.1%、53.8%。CK-MB在UAP组和SM组,Mb在SM组中有较高的阳性率,而CTnI在UAP和SM组中未检出。CTnI、Mb在AMI发生4h内就呈显著升高,三项指标的最高峰值在8～16h内均可出现,72h后Mb、CK-MB降至临界值,而CTnI7天后仍高于对照组。结论CTnI、CK-MB、Mb在AMI早期诊断价值基本相同,CTnI有更宽的诊断时间窗和独特的特异性,是AMI早期诊断的首选指标。

Objective To evaluate the diagnostic value of CTnI and Mb to the patients with acute myocardial infarction(AMI )in the early stage.Method Serum CTnI ?Mb and CK-MB were tested for26patients with AMI,41with unstable angina pectoris(UAP),30with skeletomuscular injury(SM)and30healthy persons.The chest pain in different phases of the patients with AMI was tested too.Results Positive rates of serum CTnI ?Mb and CK-MB in the patienes with AMI were65.4%,73.1%,53.8%respectively.The higher positive rates of CK-MB were observed in the patients with UAP and SM as same as Mb in the patients with SM.It was observed in the patients with AMI that CTnI and Mb raised remarkably within4hours,the climax of CTnI ?Mb and CK-MB appears in the course from8to16hours,Mb and CK-MB decreased to critical point after72hours,and CTnI is higher than that of contrast group after7days.Conclusions There has an almost same diagnostic value of CTnI ?CK-MB and Mb to acute phase of AMI ,but CTnI has a broader time window of diagnosis and speciality.It can be served as the first indicator to AMI.