摘要
目的:探讨肌钙蛋白I(cTnI)和超敏CRP(hs-CRP)在急性心肌梗死(AMI)早期诊断和心肌再梗中的价值。方法:测定131例AMI发作2 h血清cTnI、CK-MB和hs-CRP的浓度,以122健康体检者作对照,并分析受试者工作特征(ROC)曲线。结果:AMI早期血清cTnI、CK-MB和hs-CRP水平与对照组相比差异均有统计学意义(P<0.01);cTnI、hs-CRP和CK-MB三指标串联诊断心肌梗死的敏感度与特异度分别为99.8%和93.6%,优于各单个指标。通过ROC曲线确定再梗的Cutoff值,cTnI为16.8 ng/mL,CK-MB为40.5 U/L,hs-CRP为38.5 mg/L。高浓度的cTnI和hs-CRP对心肌再梗均有一定的预测意义(风险指数分别为5.5和2.9,P值<0.001和0.01),而cTnI和/或hs-CRP联合预测心肌再梗的风险指数高达9.9(P<0.0001)。结论:多种心肌标志物联合可早期快速诊断急性心肌梗死,一定水平的cTnI联合hs-CRP检测可早期预测心肌再梗。
Objective To explore the early diagnostic value of cardiac troponin-I （cTnI） combined with hs-CRP in acute myocardial infarction （AMI） and in predicting myocardial reinfaretion. Methods The serum concentrations of cardiac troponin-I,CK-MB and hs-CRP, in 131 cases with acute myocardial infarction were measured at 2 h onset, and were compared with 122 normal controls. The results were analyzed with ROC curve. Results Compared with control group, the levels of cTnI, CK-MB and hs-CRP were significantly higher in AMI group（ P 〈 0.01 ）. The sensitivity and specificity of combining cTnI, CK-MB and hs-CRP was 0. 998 and O. 936, respectively. According to ROC curve, the cutoff values of cTnI, CK-MB and hs-CRP were 16.8 ng/mL ,40.5U/L and 38.5mg/L in myocardial reinfaretion, respectively. Higher concentration CTnI and hs-CRP all played a role in predicting myocardial reinfarction （risk index was 5.5 and 2.9 ,respeetively,P 〈 0.0001 and 0.01 ）, but the risk index was increased to 9.9 when cTnl and hs-CRP was combined（ P 〈 0. 0001 ）. Conclusions Early acute myocardial infarction could be diagnosed by multiplemyocardial marker profiles rapidly, and cTnI combined with hs-CRP can effectively predict myocardial reinfarction.
出处
《郧阳医学院学报》
2008年第6期511-513,共3页
Journal of Yunyang Medical College
