【摘要】 目的 探讨心肌肌钙蛋白T(cTnT)、心肌肌钙蛋白I(cTnI)、肌酸激酶(CK)和肌酸激酶同工酶(CK-MB)定量分析对心肌损伤早期诊断的临床价值。方法 检测80例心肌梗塞(急性50例,陈旧性30例)、100例心脏手术、60例非心脏手术患者和20例健康人的血清cTnT、cTnI、CK-MB和CK,并加以分析。结果 急性心肌梗塞及心脏手术病人血清cTnT、cTnI浓度明显升高,与CK、CK-MB的升高程度相比有显著差异(P<0.01),两组患者3h内、5d后cT nT、cTnI阳性检出率明显高于CK-MB和CK。血清cTnT、cTnI、CK-MB和CK检测心肌损伤的敏感度分别为86.2％、90.9％、54.6％、64.8％,特异度分别为100％、100％、92.3％、75.4％。结论 与CK、CK-MB相比,血清cTnT、cTnI能更确切地反应心肌损伤程度,是较敏感和特异的血清标志物,应当作为心肌损伤诊断的常规指标。更多还原

【Abstract】 Objective To investigate the early diagnostic value and significance of the quantitative analysis of cardiac troponin T and I vs creative kinase ( CK) and creative kinase isoenzyme ( CK - MB) in myocardial injury caused by acute myocardial infarction and open - heart surgery. Methods The serum cTnT, cTnI, CK and CK - MB from 80 patients with myocardial infarction (including 50 cases in acute type and 30 cases in old myocardial infarction) , 100 cases with open -heart surgery, 60 cases with non -heart surgery and 20 healthy controls were tested and analyzed. Results The results showed the serum levels of cTnT, cTnI in patients with acute myocardial infarction and open-heart surgery were significantly higher than the raising levels of CK and CK - MB with great difference (P < 0. 01 ). The positive rate of the cTnT and cTnI in 3h and 5d for patients with myocardial infarction and open - heart surgery group was much higher than that of CK and CK -MB. The percentages of sensitivity in serum cTnT, cTnI, CK and CK - MB to determine the myocardial injury were 86. 2% , 90. 9% , 54. 0% , and 64. 8% , respectively. The degrees of their specificity were 100% , 100% , 92. 3% and 75. 4% , separately. Conclusion In comparison with the CK and CK - MB, the dynamic changes of the serum cTnT, cTnI level could directly reflect the degree of myocardial injury with high sensitivity and specificity suggesting that these 2 serum indicators could recommend as the reactive indicators in early diagnosis of the myocardial injury.更多还原