摘要
目的探讨心肌型肌酸激酶同工酶(CK-MB)、血清肌钙蛋白Ⅰ(cTnⅠ)、冠脉造影联合心电图在急性心肌梗死患者中的诊断效果。方法选择2017年1月至2018年10月本院住院的急性心肌梗死患者82例作为对象(观察组),所有患者均行冠状动脉造影检查;选择同期健康体检者40例(对照组)。两组入院后均采用全自动生化分析仪测定CK-MB水平;采用化学发光分析仪测定cTnⅠ水平;观察组所有患者均完成心电图检查,绘制ROC曲线,分析CK-MB、cTnⅠ、冠脉造影联合心电图在急性心肌梗死患者中的诊断效能(敏感性、特异性)。结果冠脉造影下急性心肌梗死患者以前降支为主,占50.98%,其次为右冠,占52.44%、回旋支13.73%、左主干1.96%;病变血管以单支病变为主,占62.75%;心电图检查阳性43例(84.31%);观察组急性心肌梗死患者CK-MB、cTnⅠ水平均高于对照组健康体检者(P<0.05);ROC曲线结果表明CK-MB、cTnⅠ、冠脉造影联合心电图在急性心肌梗死患者中的诊断敏感性、特异性均高于单一CK-MB、cTnⅠ、冠脉造影、心电图(P<0.05)。结论CK-MB、cTnⅠ在急性心肌梗死患者中表达异常,联合心电图、冠脉造影检查能提高急性心肌梗死患者确诊率,可获得较高的诊断敏感性、特异性,值得推广应用。
Objective To investigate the diagnostic effect of myocardial creatine kinase isoenzyme(CK-MB),serum troponin I(cTnⅠ),coronary angiography and electrocardiogram in patients with acute myocardial infarction.Methods From January 2017 to October 2018,82 patients with suspected acute myocardial infarction were selected as the observation group,and all patients were diagnosed by coronary angiography.40 healthy patients during the same period were selected as the control group.After admission,both groups were measured the CK-MB level using automatic biochemical analyzer.Chemiluminescence analyzer was used to measure cTnⅠlevel.All patients in the observation group completed electrocardiogram examination.The ROC curve was drawn to analyze the diagnostic efficacy(sensitivity,specificity)of CK-MB,cTnⅠ,coronary angiography combined with ECG in patients with acute myocardial infarction.Results Patients with acute myocardial infarction under coronary angiography were mainly descended,accounting for50.98%,followed by the right coronary artery 33.33%,circumflex branch 13.73%,left main trunk 1.96%.The diseased blood vessels were mainly single branch lesions,accounting for 62.75%.43 patients(52.44%)were positive in electrocardiogram.The levels of CK-MB and cTnⅠwere higher than those in the control group(P<0.05).The ROC curve results showed that the diagnostic sensitivity and specificity of CK-MB,cTnⅠ,coronary angiography and electrocardiogram in patients with acute myocardial infarction were both higher than that of single CK-MB,cTnⅠ,coronary angiography,electrocardiogram(P<0.05).Conclusion CK-MB and cTnⅠare abnormally expressed in patients with acute myocardial infarction.Combined with electrocardiogram and coronary angiography can improve the diagnosis rate of patients with acute myocardial infarction,and obtain high diagnostic sensitivity and specificity,which is worthy of promotion and application.
作者
常琳
常佩云
刘娟
CHANG Lin;CHANG Peiyun;LIU Juan(Electrocardiogram room of bozhou people's hospital,Bozhou,Anhui,China,236000;Internal medicine of bozhou people's hospital,Bozhou,Anhui,China,236000;Department of cardiology,bozhou people's hospital,Bozhou,Anhui,China,236000)
出处
《分子诊断与治疗杂志》
2020年第8期1018-1021,共4页
Journal of Molecular Diagnostics and Therapy
基金
国家自然科学基金项目(81670332)。
关键词
心肌型肌酸激酶同工酶
血清肌钙蛋白Ⅰ
冠脉造影
心电图
急性心肌梗死
诊断效果
Myocardial creatine kinase isoenzyme
Serum troponinⅠ
Coronary angiography
electrocardiogram
Acute myocardial infarction
Diagnostic effect
