摘要
目的探讨肌红蛋白(Mb)与心肌肌钙蛋白Ⅰ(cTnI)急诊联合快速检测对急性心肌梗死(AMI)的早期诊断价值。方法对胸痛发作2～6h或临床疑为AMI的急诊病者86例,急诊采取静脉全血用Mb、cTnI联合试板测定Mb、cTnI和Mb+cTnI,分析其诊断AMI的敏感性、特异性、准确性,并将阳性预测值与阴性预测值作比较。结果Mb敏感性为96.1%,阴性预测值为91.7%明显高于cTnI的88.2%和85.2%(P<0.05或P<0.01);但cTnI的特异性97.1%,准确性91.9%和阳性预测值97.8%,分别高于Mb的62.9%、82.6%和79.0%(P<0.05或P<0.01);采用Mb+cTnI联合检测其特异性、阳性预测值和阴性预测值均达100%,高于单独Mb及cTnI的检测(P<0.01)。结论Mb和cTnI联合快速检测可使其敏感性和特异性得到最佳体现,对AMI的早期诊断具有重要的价值,并具有快速、准确、方便、经济等优点,在急诊的应用有较好的前景。
Objective To evaluate the early diagnostic value of rapid test in combination with myoglobin （Mb） and cardiac troponin Ⅰ （cTnⅠ） for the patients with acute myocardial infarction （AMI） in emergency. Methods Eighty-six patients with chest pain for 2h-6h or doubled AMI, venous blood were collected in emergency. Mb, cTnⅠ and Mb ＋ cTnⅠ Were tested by combinative experimental discuss. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value were compared for diagnosis of AMI. Results Sensitivity was 96. 1% and negative predictive value was 91.7% of Mb, that were higher than 88.2% and 85.0% of cTnⅠ （P 〈0. 05 or P 〈0. 01 ） . The specificity, accuracy and positive predictive value were 97. 1% , 91.9% and 97.8% of cTnI, that were higher than 62.9%, 82.6% and 79.0% of Mb （P 〈 0. 05 or P 〈 0. 01 ） . But the specificity, positive predictive value and the negative predictive value were 100% with test in combination with Mb and cTnI, that were higher than the individual test （ P 〈 0. 01 ） . Conclusion It is important early diagnostic value for AMI, that the sensitivity and specificity are best in test in combination with Mb and cTnI. There are merits of rapid, accuracy, simple, convenience and economy. It has a bright future for early diagnosis of AMI in emergency.
出处
《广州医药》
2007年第3期22-24,共3页
Guangzhou Medical Journal
