心肌三项在急性心肌梗死诊断意义

【摘要】 目的:探讨心肌三项在早期诊断急性心肌梗死(AMI)中的价值。心肌三项包括肌钙蛋白T(cTnT)、肌红蛋白(Mb)和肌酸激酶同工酶(CKMB)。方法:回顾近年收治的AMI患者76例,男55例,女21例,平均年龄63.24±20.21岁,有较明确的发病时间,检测cTnT、Mb、CKMB,对上述指标进行对比研究。结果:胸痛发作时间在4小时以内、4小时、5～11小时及大于12小时首次测定cTnT阳性率分别为41.18%、50.00%、52.38%和47.37%,测定Mb阳性率分别为81.18%、86.12%、51.38%和42.37%,测定CK-MB阳性率分别为70.59%、85.71%、95.24%和89.47%,Mb在胸痛发作8小时达最高峰,12小时开始下降。CK-MB在各时间段阳性率均达到70%以上,且阳性率随胸痛发作时间有逐渐上升趋势,而Mb的阳性预测值明显高于cTnT的阳性预测值(P<0.01),但与CK-MB的阳性预测值差异无统计学意义(P>0.05)。结论:心肌三项在AMI早期诊断中具有较高的特异性和灵敏度,三者结合可能提高早期AMI的诊断率,避免不典型患者的漏诊。更多还原

【Abstract】 Objective:To investigate the value of serum cardiac troponin T(cTnT),myoglobin(Mb) and creatine kinase isoenzyme MB(CKMB) levels in the early diagnosis of the patients with acute myocardial infarction (AMI).Methods:76patients(55males and21females,mean age63.24±20.21years)admitted to the hospital suffering from AMI were studied in a retrospective analysis.Among them.The symptoms of chest pain were recorded,cTnT、Mb、CKMBwere examined on admission.Results:The time of onset of chest pain was divided into 4 segments of<4hours,4hours,5～11hours and>12hours.The positive rate of cTnT in the determination was41.18%,50.00%,52.38%and47.37%,The positive rate of Mb in the determination was81.18%,86.12%、51.38%和42.37%,while that of CK-MB was70.59%、85.71%、95.24%和89.47%,Mb was top when the time of onset of chest pain was 8hours,Mb started to descend after the time of onset of chest pain was 12hours.The overall positiverate of CK-MB was higher than70%.According to the time of the episodes of chest pain,the positive rate tended to rise as well.The positive rate of Mb was higher than that of cTnT(P<0.01 No significant differennce was observed in the positive rate Mb and CK-MB P>0.05).Conclusion:Mb、cTnT and CK-MB have a high specificity and sensitivity in the earlydiagnosis of AMI.If they are measured together,the early diagnosis rate may beimproved,and miss in the diagnosis of atypical patients can be avoided.更多还原