【摘要】 目的探讨血浆超敏肌钙蛋白I(hs-c Tn I)对心肌梗死和脑血管意外患者的临床诊断效果。方法随机选取2016年6月至2017年12月本院收治的急性冠脉综合征患者197例,分为不稳定性心绞痛(UA)组(48例)和急性心肌梗死(AMI)组(149例),AMI组又分为急性非ST段抬高性心肌梗死(NSTEMI)(53例)和急性ST段抬高性心肌梗死组(STEMI)(96例),同时选取脑血管意外(CVA)组(45例),健康对照组30例,采用贝克曼公司最新的Accuc Tn I 3+检测试剂,监测病人和正常人血浆hs-c Tn I变化,同时检测传统的心肌标记物,并做对比研究。结果对照组,UA组,NSTEMI组,STEMI组和CVA组病人血清hs-c Tn I浓度分别为(0.01±0.01)ng/m L,(0.08±0.03)ng/m L,(2.07±0.58)ng/m L,(2.12±0.64)ng/m L,(0.05±0.03)ng/m L,NSTEMI组和STEMI组hs-c Tn I浓度均明显高于正常对照组(P<0.05);AMI患者胸痛时间<3 h、<6 h和<24 h组hs-c Tn I的ROC曲线下面积分别为0.86(95%CI:0.79~0.93)、0.99(95%CI:0.97~1.01)和0.99(95%CI:0.95~1.01),明显高于传统心肌标记物肌红蛋白(MYO)、肌酸磷酸激酶同工酶(CK-MB)和超敏C反应蛋白(hs-CRP);AMI患者胸痛时间<3 h、<6 h和<24 h组中,hs-c Tn I阳性检出率分别为72.0%、94.7%和100.0%;UA组和CVA组病人hs-c Tn I的阳性检出率分别为35.4%和13.3%。结论定量检测血浆hs-c Tn I含量对于早期心梗的诊断具有非常重要的应用价值。更多还原

【Abstract】 Objective To explore the clinical diagnosis value of plasma high-sensitive cardiac troponin I(hs-c Tn I)in patients with myocardial infarction or cerebrovascular accident.Methods 197 acute coronary syndrome patients were divided into acute myocardial infarction(AMI)group(149 cases)and unstable angina pectoris(UA)groups(48 cases).Group AMI were divided into non-ST-segment elevation myocardial infarction(NSTEMI)group(53 cases)and ST-segment elevation myocardial infarction(STEMI)group(96 cases).45 cerebrovascular accident(CVA)patients and 30 healthy subjects were selected in our hospital from June 2016 to December 2017.The concentration of hs-c Tn I was detected with Accuc Tn I 3+ reagents of Beckman Coulter,Inc.At the same time,the traditional biomarkers were also detected.Results The concentration of hs-c Tn I of normal control group,UA group,NSTEMI group,STEMI group and CVA group were(0.01±0.01)ng/m L,(0.08±0.03)ng/m L,(2.07±0.58)ng/m L,(2.12±0.64)ng/m L,(0.05±0.03)ng/m L,respectively.The concentration of hs-c Tn I of NSTEMI and STEMI group were significantly higher than that of normal control group(P<0.05).The ROC curve areas of hs-c Tn I of chest pain onset <3 h,<6 h and <24 h of patients with AMI were 0.86(95%CI: 0.79~0.93),0.99(95% CI: 0.97~1.01)and 0.99(95% CI: 0.95~1.01),which were significantly higher than the traditionalmyocardial marker myoglobin(MYO),creatine kinase M and B isoform(CK-MB)and hypersensitive C-reactive protein(hsCRP).The hs-c Tn I positive detection rates of chest pain onset <3 h,<6 h and <24 h of patients with AMI were 72.0%,94.7% and 100.0%,respectively.In addition,the hs-c Tn I positive detection rates of UA and CVA group were 35.4% and13.3%,respectively.Conclusion Quantitative detection of the plasma hs-c Tn I concentration is very important for the diagnosis of early myocardial infarction.更多还原