【摘要】 目的对肌酸激酶及其同工酶(CK、CK-MB)和心肌肌钙蛋白T(cTnT)进行比较,为急性心肌梗死(AMI)的早期诊断和不良预后评估提供较合理的检测指标。方法对123例高度可疑的AMI患者在入院后24h内检测CK、CK-MB活性和cTnT,比较它们对AMI诊断的敏感性和特异性,并进行优化组合。结果(1)在入院后24h内CK、CK-MB活性和cTnT对AMI的敏感性分别为89.3%、77.7%和94.2%,特异性分别为80%、100%和100%;(2)AMI患者随着cTnT水平的升高短期(1个月)死亡率显著增加(P<0.01),从4.3%(cTnT≤0.4ng/ml)、15.4%(0.4~1.0ng/ml)到30.2%(≥1.0ng/ml)。(3)CK与cTnT联合检测对AMI的敏感性为97.1%,特异性为80%;(4)CK-MB活性出现阳性时,cTnT均阳性,而且同一标本cTnT升高程度显著高于CK-MB(P<0.05)。结论CK与cTnT联合检测对诊断AMI具有高度的敏感性和特异性,在此基础上再检测CK-MB活性不会增加其敏感性和特异性。更多还原

【Abstract】 Objective To detect and compare CK,CK-MB activity and cTnT in coronary sclerosis patients,and to find better markers for diagnosis of acute myocardial infarction.Methods A series of blood samples from 123 suspicious AMI patients were collected within 24h after symptom onset,then CK,CK-MB(activity) and cTnT were detected and compared,and then selected cardiac markers with better sensitivity and specificity for the detection of acute myocardial infarction.Results(1)The sensitivities of CK,CK-MB(activity) and cTnT for diagnosis of acute myocardial infarction were(89.3)%,77.7% and 94.2% respectively,the specificity were 80%,100%and 100% respectively.(2)The elevation of cTnT trial noted a strong correlation with mortality at 30d in AMI patients,from(4.3)%(≤0.4ng/ml) to 15.4%(0.4-1.0ng/ml) and 30.2%(≥1.0ng/ml).(3)The sensitivity and specificity of detecting CK and cTnT in chorus for AMI were 97.1% and 80% respectively.(4)Specimen with CK-MB positive was all cTnT positive,and the elevated degree of cTnT from the same specimen was higher than that of CK-MB.Conclusion Detection of CK and cTnT in chorus had a better sensitivity and specificity in diagnosis of AMI.The detection of CK-MB activity could not do them better.更多还原