急性心肌梗死患者CK-MB、cTnI和cTnT的动态变化及其联合检测的诊断价值

摘要

目的 探讨肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)和心肌肌钙蛋白T(cTnT)在急性心肌梗死(AMI)早期的动态变化及其联合检测的诊断价值.方法 将因急性胸痛发作就诊的患者分为AMI组(70例)和非AMI组(66)例,在发病后不同时间点检测并比较CK-MB、cTnI和cTnT水平.结果胸痛发作后≤3 h、＞3~6 h、>6~12 h、＞12~24 h和＞24~48 h AMI组CK-MB、cTnI和cTnT水平均高于非AMI组,差异有统计学意义(P<0.05);3项指标联合检测诊断AMI的灵敏度和特异度分别为97.14%和90.91%,均高于单独检测.结论 联合检测CK-MB、cTnI和cTnT可明显提高AMI 早期诊断的灵敏度和特异度.%Objective To explore the clinical significance of Creatine kinase MB (CK-MB) ,cardiac troponin I (cTnI) and cardiac troponin T (cTnT) in the early diagnosis of acute myocardial infarction (AMI). Methods One hundred and thirty-six patients with acute chest pain were involved in this study. Venous blood was collected from each patient at different time to detect CK-MB, cTnI and cTnT. All patients were divided into AMI group (n = 70) and non-AMI group (n = 66) ,and their detection results of CK-MB, cTnI and cTnT were compared. Results All of the levels of CK-MB,cTnI and cTnT on ≤3 h,3~6 h,>6~12 h,12 ~ 24 h and > 24 ~ 48 h after chest pain were higher in AMI group than those in non AMI group (P<0. 05). The combination detection of sensitivity and specificity for acute myocardial infarction with CK-MB, cTnI and cTnT were 97. 14% and 90. 91% respectively, which were higher than those detected single. Conclusion The combination detection of CK-MB, cTnI and cTnT can improve sensitivity and specificity of diagnosis of acute myocardial infarction, which are in accordance with the diagnosis of coronary arteriongraphy.