摘要
目的研究肌钙蛋白I(cTnI)和高敏肌钙蛋白I(hs-cTnI)在远端冠脉阻塞后微小心肌损伤(MMD)中的诊断价值。方法随机选取240例胸痛入院患者作为观察组,其中175例已确诊有冠脉阻塞的心肌损伤患者(ZMMD组)、39例无冠脉阻塞的心肌损伤患者(WMMD组),26例非缺血性胸痛患者(NICP组),入院后抽血并测定ZMMD组、WMMD组、NICP组三组入院即刻(0 min),入院后30 min、90 min、120 min血清中cTnI和hs-cTnI的水平,另选90例健康体检者作为对照组。采用胶体金免疫层析法(GICA)检测血清cTnI水平,荧光免疫层析法检测hs-cTnI水平。结果观察组血清cTnI和hs-cTnI水平均明显高于对照组,差异有统计学意义(P <0. 05); ZMMD组和WMMD组中cTnI和hs-cTnI水平均高于NICP组和对照组,差异有统计学意义(P <0. 05),ZMMD组与WMMD组cTnI和hs-cTnI水平无显著差异。ZMMD组和WMMD组入院即刻血清样本hs-cTnI的阳性率分别为92. 6%和93. 1%,高于c Tn T阳性率69. 2%和65. 3%,差异有统计学意义(P <0. 05)。ZMMD组hs-cTnI入院4个不同时间点(0 min、30 min、90 min、120min)阳性率高于cTnI阳性率,hs-cTnI阳性率最高为99. 5%(入院30min后),cTnI阳性率最高为98. 2%(入院90 min后)。结论 cTnI和hs-cTnI是诊断远端冠脉阻塞后MMD的生理指标,且在远端冠脉阻塞MMD患者早期血清中hscTnI比cTnI更敏感。
Objective To investigate the diagnostic value of cardiac troponin I(cTnI)and hyper sensitivity cardiac troponin I(hs-cTnI)in minor myocardial damage(MMD)after distal coronary occlusion.Methods A total of 240 patients admitted to hospital for chest pain were randomly selected as the observation group including 175 cases previously diagnosed with myocardial infarction(ZMMD group)after distal coronary occlusion,39 cases newly diagnosed without distal coronary occlusion(WMMD group),26 cases were the non-eschemic chest pain group(NICP group).Blood was collected after admission and the levels of cTnI and hs-cTnI in the serum of the three groups(immediately after admission,30 min,90 min,and 120 min after admission)were measured,and 90 healthy subjects were selected as control group.Serum cTnI levels were detected by gold immunochromatography assay(GICA)and hs-cTnI levels were detected by fluorescence immunochromatography.Results The serum levels of cTnI and hs-cTnI in observation group were significantly higher than those in control group(P<0.05).The serum levels of cTnI and hs-cTnI in ZMMD group and WMMD group were significantly higher than those in NICP group and control group(P<0.05).The positive rates of hs-cTnI(92.6%and 93.1%)collected immediately after admission were higher than those of cTnI(69.2%and 65.3%)in the ZMMD group and WMMD group(P<0.05).The positive rates of hs-cTnI at 4 different time points(immediately after admission,30 min,90 min and 120 min)were higher than that in ZMMD group.The positive rate of hs-cTnI in the ZMMD group reached the highest(99.5%)after admission for 30 minutes and the highest positive rate of cTnI was 98.2%after admission for 90 minutes.Conclusion CTnI and hs-cTnI can be selected as markers of MMD,and serum hs-cTnI is more sensitive than cTnI for early diagnosis of MMD after distal coronary occlusion.
作者
霍燕飞
马美芳
田洪森
HUO Yan-fei;MA Mei-fang;TIAN Hong-sen(Department of Cardiology,Handan Central Hospital,Handan Hebei 056002,China.)
出处
《临床和实验医学杂志》
2019年第5期495-498,共4页
Journal of Clinical and Experimental Medicine
