急性冠状动脉综合征早期诊断中血清Mb、CK-MB和CTnI水平测定的临床应用

摘要

目的 探讨血清Mb、CK-MB和CTnI水平测定在急性冠状动脉综合征(ACS)发病早期诊断和溶栓再通效果监测的临床应用.方法 利用生化和化学发光方法测定了96例ACS患者(包括52例UAP和44例AMI)血清中的Mb、CK-MB和CTnI的水平,在监测溶栓治疗的44例AMI中,测定了32例通畅组和12例持续闭塞组溶栓治疗后60min和溶栓治疗前的浓度比值,并进行了比较分析.结果 在96例ACS患者中,44例AMI患者血清Mb、CK-MB和CTnI水平分别为181±102μg/L,55±32U/L和0.560±0.310μg/L,显著高于52例UAP患者和42名正常对照组(P<0.05),UAP患者和正常对照组无明显差异(P>0.05).在监测44例AMI患者相关动脉的溶栓治疗中,32例AMI患者通畅组溶栓治疗后60min与治疗前的浓度比值分别为7.4±1.5、20.2±2.4和3.0±0.4,较之12例持续闭塞组明显增高(P<0.05).结论 血清Mb、CK-MB和CTnI水平的联合测定是早期诊断ACS有效方法,并且是监测AMI患者溶栓治疗效果的有意义指标.%Objective In order to explore the clinical application of measuring serum Mb,CK-MB and CTnI levels in early diagnosis and monitoring the effect of thrombolysis of acute coronary syndrome(ACS).Methods The serum Mb,CK-MB and CTnI levels in 96 patients with ACS(including 52 cases UAP and 44 cases AMI) were measured by biochemistry.In monitoring the effect of thormbolysis,the serum Mb,CK-MB and CTnI levels at different time points were studied too.Result The concentration of Mb,CK-MB and CTnI levels in 44 patients with AMI were 181 ± 102 μg/L,55 ± 32U/L and 0.560 ± 0.310 μg/L,respectively,which were significantly higher than that in the UAP(P＜0.05) and the healthy controls(P＜0.05).Those levels in 52 patients with UAP had no difference when comparing with healthy controls(P＞0.05).In monitoring 44 patients with AMI of thrombolysis therapy with AMI,they were 7.4± 1.5,20.2±2.4 and 3.0±0.4,respectively,but in 12 patients with AMI no effect thrombolysis therapy, they were 2.1 ± 0.3,9.8 ± 1.3 and 1.1 ± 0.2 respectively.Conclusion The Mb,CK-MB and CTnI levels were a sensitive and reliable criteria for early diagnosis of ACS,and can also reflect the effect of thyombolysis therapy.It can be more significant combining the CK,CK-MB and CTnI.