摘要
目的探讨血清心肌损伤标志物对急性心肌梗死(AMI)早期诊断的临床价值。方法选择2017年1月—6月夏津县人民医院61例确诊为AMI的患者作为AMI组,另选33例健康体检人群作为健康对照组,分别采集健康对照组静脉血以及AMI组发病2、4、8、12 h静脉血。采用免疫散射比浊法检测超敏C-反应蛋白(hs-CRP),采用化学免疫发光法检测心肌肌钙蛋白I(c TnI)、心肌肌钙蛋白T(c TnT)、肌红蛋白(Mb)、肌酸激酶同工酶(CK-MB),比较两组各指标含量差异。结果 AMI患者胸痛发病2 h hs-CRP、Mb较健康对照组明显升高〔hs-CRP(mg/L):3.62±2.81比0.73±0.68,Mb(μg/L):137.81±78.52比46.25±27.42,P<0.05〕,其余指标无明显变化(P>0.05);4、8、12 h hs-CRP、Mb、cTnI、cTnT、CK-MB随时间延长逐渐升高,较健康对照组均明显升高〔hs-CRP(mg/L):24.51±16.22、47.34±19.87、50.27±21.74比0.73±0.68,Mb(μg/L):208.61±96.25、331.37±117.23、226.14±131.37比46.25±27.42,cTnI(μg/L):6.74±4.79、18.26±12.41、31.47±20.13比0.012±0.010,cTnT(g/L):17.22±8.36、39.37±21.12、59.82±32.77比6.91±4.82,CK-MB(μg/L):13.21±10.52、57.87±31.14、81.38±40.71比1.27±0.97,均P<0.05〕。2、4、8、12 h hs-CRP敏感度分别为44.26%、91.8%、98.36%、98.36%,特异度分别为53.29%、86.2%、96.32%、97.32%;CK-MB敏感度分别为0%、59.02%、96.72%、98.36%,特异度分别为0%、79.43%、91.47%、93.62%;cTnI敏感度分别为0%、62.3%、93.44%、100%,特异度分别为0%、88.27%、97.19%、100%;cTnT敏感度分别为0%、54.1%、88.52%、100%,特异度分别为0%、78.94%、92.58%、100%;Mb敏感度分别为52.46%、88.53%、96.72%、96.72%,特异度分别为47.43%、74.28%、81.24%、81.24%。结论及时检测hs-CRP、cTnI、cTnT、Mb、CK-MB有助于AMI的早期诊断。
Objective To study the early clinical diagnostic value of myocardial damage markers in patients with acute myocardial infarction (AMI). Methods A total of 61 patients with definite diagnosis of AMI were enrolled as an experimental group, 33 healthy subjects having undergone physical examinations were assigned in a healthy control group, and all the patients were selected from the People's Hospital of Xiajin County between January to June in 2017. The venous blood samples werecollected from the healthy control group and AMI experimental group respectively at 2, 4, 8, 12 h after AMI onset. The immune scatter turbidity method was used to detect high sensitivity C-reactive protein (hs-CRP), chemical immunofluorescence technique was applied to test cardiac troponine I (cTnI), cardiac troponine T (cTnT), myoglobin (Mb), creatine kinase isoenzyme (CK-MB), and the level differences of above indexes were compared between the two groups. Results The hs-CRP and Mb levels were significantly higher in patients with AMI than those of normal control group after 2 h AMI patients' onset of chest pain [hs-CRP (mg/L): 3.62±2.81 vs. 0.73±0.68, Mb (μg/L): 137.81±78.52 vs. 46.25±27.42, both P < 0.05] and the changes of other indicators were not significant (allP > 0.05);with the prolongation of time, the levels of hs-CRP, Mb, cTnI, cTnT and CK-MB in AMI group of patients were increased gradually at 4, 8, 12 h after AMI onset, and they were significantly higher than those of the healthy control group [hs-CRP (mg/L): 24.51±16.22, 47.34±19.87, 50.27±21.74 vs. 0.73±0.68, Mb (μg/L): 208.61±96.25, 331.37±117.23, 226.14±131.37 vs. 46.25±27.42, cTnI (μg/L): 6.74±4.79, 18.26±12.41, 31.47±20.13 vs. 0.012±0.010, cTnT (g/L): 17.22±8.36, 39.37±21.12, 59.82±32.77 vs. 6.91±4.82, CK-MB (μg/L): 13.21±10.52, 57.87±31.14, 81.38±40.71 vs. 1.27±0.97, all P < 0.05]. The sensitivity of hs-CRP was 44.26%, 91.8%, 98.36%, 98.36% at 2, 4, 8, 12 h respectively and the specificity was 53.29%, 86.2%, 96.32%, 97.32% at 2, 4, 8, 12 h resp
作者
姚磊
Yao Lei(Department of Laboratory,Xiajin County People's Hospital,Dezhou 253200,Shandong,China)
出处
《实用检验医师杂志》
2019年第1期26-29,共4页
Chinese Journal of Clinical Pathologist
关键词
心肌梗死
急性
超敏C-反应蛋白
肌钙蛋白
肌红蛋白
肌酸激酶同工酶
Myocardial infarction, acute
High sensitivity C-reactive protein
Cardiac troponin
Myoglobin
Creatine kinase isoenzyme MB
