【摘要】 目的总结笔者所在医住院部急性心肌梗死(AMI)患者的诊断资料,评价和分析急性心肌梗死应用心肌肌钙蛋白T(cTnT)检测的应用诊断价值。方法收集住院部急性心肌梗死的临床资料(包括临床病史、心电图、心肌酶谱、心脏彩色超声),对每例的首发症状、起病时间、既往史等进行归类和总结,分析比较cTnT与肌酸肌酶同工酶CK-MB、心电图(ECG)检测结果,进行统计学分析。结果 cTnT检测对早期急诊AMI(2～6 h)的阳性率不高(74.42%),在发病时间6 h至8 d内,具有较高特异性和准确性(其阳性率>90.0%),明显高于ECG、CK-MB检测的阳性率,差异具有显著性;cTnT检测对于心内膜微小心肌损伤、心肌毒性物质及机械损伤等原因所致的心脏病患者(9例)不具有明显的特异性。结论 cTnT检测用于急性心肌梗死的诊断具有灵敏度高、特异性强、持续时间长、报告结果快速准确等特点,效果明显优于ECG、CK-MB检测,是快速确诊AMI较为理想的生化标志物,与其联合检测可以提高早期AMI的检出率及诊断时间窗。更多还原

【Abstract】 Objective Summarizing the diagnostic materials of the acute myocardial infarction(AMI) inpatients,to evaluation and analysis the application value of cardiac troponin(cTnT) in the disease of acute myocardial infarction.Methods Collecting the AMI inpatients’ clinical data(including clinical history,electrocardiogram,myocardial enzyme,heart color ultrasonic).Categorizing and summarizing the first symptom,onset time,previous history,etc.Comparison cTnT with CK—MB or electrocardiogram(ECG),analyzing their test results and making statistical analysis.Results For early detection, the positive rate of cTnT(2-6 h) was not high(74.42%).And in time of 4 h -8 d,it presents high specificity and accuracy rate(>90.0%).The positive rate was obviously higher than ECG and CK - MB,which of two had significant difference.cTnT test has no obvious specificity for the heart patients(9 cases) whose disease was caused by endocardial tiny myocardial injury,myocardial toxic substance and mechanical damage,and so on.Conclusion cTnT detection for the diagnosis of acute myocardial infarction was high sensitivity and specificity,duration,and reporting the results quickly and accurately, etc.It is obviously superior to ECG,CK - MB,and it is the rapid diagnosis of AMI as a ideal biochemical marker. Combining with others,it can improve the detectable rate of AMI in early stage and had a wider diagnostic time window.更多还原