【摘要】 目的探讨肌酸激酶同工酶(CK-MB)、钠尿肽(BNP)、肌红蛋白(MYO)、心脏型脂肪酸结合蛋白(H-FABP)及高敏肌钙蛋白(hs-cTnⅠ)联合检测急性心肌梗死(AMI)的临床意义。方法选取攀枝花市中心医院急诊科2015年12月至2017年8月期间收治的120例胸痛3 h内的急诊患者,根据AMI诊断标准分为AMI组(n=67)及非AMI组(n=53)。收集两组患者的CK-MB、BNP、MYO、H-FABP及hs-cTnⅠ水平,分析5种指标联合检测和单一检测的特异性及敏感性。结果 AMI组患者的CK-MB、BNP、MYO、H-FABP及hs-cTnⅠ水平均高于非AMI组,差异均具有统计学意义(P<0.05);CK-MB、BNP、MYO、H-FABP及hs-cTnⅠ联合检测的特异度、敏感度、约登指数分别为90.91%、96.30%、0.87,联合检测的特异度、约登指数均高于单一CK-MB、BNP、MYO、H-FABP及hs-cTnⅠ单独应用时,差异均具有统计学意义(P<0.05);联合检测时的灵敏度高于BNP、MYO单独应用时(P<0.05)。结论 CK-MB、BNP、MYO、H-FABP及hs-cTnⅠ联合检测对早期诊断急性心肌梗死具有较高的诊断价值。更多还原

【Abstract】 Objective To investigate the clinical significance of combined detection of creatine kinase isozyme(CK-MB), brain natriuretic peptide(BNP), myoglobin(MYO), heart-type fatty acid binding protein(H-FABP) and high-sensitivity cardiac troponin I(hs-cTnⅠ) in patients with early acute myocardial infarction(AMI). Methods A total of 120 patients with chest pain within 3 hours treated in Department of Emergency, Panzhihua Central Hospital were selected from December 2015 to August 2017. According to the criteria of AMI diagnosis, they were divided into AMI group(n=67) and non-AMI group(n=53). The levels of CK-MB, BNP, MYO, H-FAB and hs-cTnⅠ were collected, and the specificity and sensitivity of the combined detection and single detection were analyzed. Results The levels of CK-MB, BNP, MYO, H-FABP and hs-cTnⅠ in AMI group were significantly higher than those of non-AMI group,with statistically significant differences(P<0.05). The specificity and sensitivity of combined detection, Youden index of combined detection were 90.91%, 96.30%, 0.87, respectively. The specificity of combined detection was significantly higher than that of single CK-MB, BNP, MYO, H-FABP and hs-cTnⅠ, with statistically significant difference(P<0.05). The sensitivity of combined detection was higher than that of BNP and MYO alone, with statistically significant difference(P<0.05). Conclusion The combined detection of CK-MB, BNP, MYO, H-FABP and hs-cTnⅠ has high diagnostic value in early diagnosis of acute myocardial infarction, which is worthy of clinical popularization.更多还原