血清高敏心肌肌钙蛋白T对急性心肌梗死早期诊断的价值

摘要

Objective To investigate the value of level of serum high-sensitivity cardiac troponin T (hs-cTnT) to the early diagnosis of acute myocardial infarction (AMI).Methods AMI patients (n=80) were chosen into AMI group (hospitalized within 6 h after AMI onset), and patients with chronic heart failure (CHF,n=40) were chosen into CHF group, and health controls (n=40) were chosen into control group from the Second Hospital of Deyang City from Mar. 2016 to Mar. 2017. The levels of serum hs-cTnT, myoglobin (MYO), cardiac troponin T (cTnT) and creatine kinase-M B isoenzyme (CK-MB) were detected in 3 groups. The value of hs-cTnT to AMI diagnosis was analyzed.Results The levels of serum hs-cTnT, MYO, cTnT and CK-MB were significantly higher in AMI group than those in CHF and control group (all P<0.05). The level of serum hs-cTnT was significantly correlated to MYO, cTnT and CK-MB (r=0.479, 0.714, 0.520, all P<0.05). The level of serum hs-cTnT was detected within 6 h after AMI onset and receiver operating characteristic curve (ROC) was drawn. When the best critical value of serum hs-cTnT was 0.050 ng/mL, the sensitivity was 98.96%, specificity was 97.33%, omission diagnostic rate was 1.04%, the misdiagnosis rate was 2.67%, and area under curve (AUC) of ROC was 0.969.Conclusion hs-cTnT has higher sensitivity and specificity in early diagnosis of AMI.%目的 探讨血清高敏心肌肌钙蛋白T(hs-cTnT)对于急性心肌梗死(AMI)早期诊断的价值.方法 选取2016年3月~2017年3月于德阳市第二人民医院确诊的80例AMI患者纳入AMI组,发病6 h内入院;40例心内科确诊的慢性心力衰竭(CHF)患者纳入CHF组;40例健康体检者纳入对照组.检测3组血清hs-cTnT、肌红蛋白(Myo)、心肌肌钙蛋白T(cTnT)、肌酸激酶同工酶(CK-MB)水平.分析hs-cTnT诊断AMI的价值.结果 AMI组的血清hs-cTnT、Myo、cTnT、CK-MB水平均显著高于CHF组和对照组,差异均具有统计学意义(P均<0.05).AMI组患者的血清hs-cTnT与Myo、cTnT、CK-MB均呈显著的正相关,相关系数分别为0.479、0.714、0.520(P均<0.05).发病6 h内检测AMI患者的血清hs-cTnT水平,绘制受试者工作特征曲线(ROC),hs-cTnT取0.050 ng/mL时为最佳临界值,此时灵敏度为98.96%、特异度为97.33%、漏诊率为1.04%、误诊率为2.67%、ROC曲线下面积(AUC)值为0.969.结论hs-cTnT诊断早期AMI具有较高的灵敏度与特异度.