联合检测Myo、cTnI、IL-6、hs-CRP在急性心梗中的临床应用

摘要

探讨血清肌红蛋白(Myo)、心肌肌钙蛋白I(cTnI)、IL-6、hs-CRP在急性心肌梗死(AMI)中的临床应用.取诊断明确的AMI发作2~6 h内住院患者58例为AMI组,于入院时、入院12 h、入院24 h、入院72 h采静脉血,另取60例查体健康者为对照组,化学发光测Myo、cTnI、IL-6及hs-CRP水平,比较其变化.结果表明,AMI组血清Myo、cTnI、IL-6、CRP水平均高于健康组,有统计学意义(P<0.05).AMI者血清Myo、cTnI水平在入院后24 h达到峰值.AMI者入院24 h血清Myo、cTnI检测AMI的敏感率分别为87.93%、94.83%,特异性分别为98.21%、98.21%.血清Myo、cTnI、IL-6、CRP四项联合检查对诊断AMI的敏感性提高不大.cTnI与Myo、cTnI与hs-CRP、hs-CRP与IL-6、Myo与IL-6存在相关关系.血清Myo、cTnI检测在AMI早期诊断中有重要作用,联合IL-6、CRP检查对诊断AMI意义不大.%Discuss serum myohemoglobin(Myo),cardiac troponinI(cTnI),IL-6 and hs-CRP application in acute myocardial infarction(AMI).Method:Take 58 inpatients as AMI group which had been AMI for 2 to 6 hours,sampling venous blood just at hospital,at 12 h after hospital,at 24 h after hospital and at 72 h after hospital;in addition,take 60 healthy people as control group,test Myo,cTnI,IL-6 and hs-CRP level by chemiluminiscence and compare the change.Result:Myo,cTnI,IL-6 and CRP level in AMI are all higher than that of healthy group,having statistical significance (P < 0.05 ).In AMI,Myo,cTnI level in serum reached peak at 24 h after hostipal.When detecting Myo,cTnI in AMI 24h after hospital,sensitivity of AMI are respectively 87.93%,94.83%,specificity 98.21%,98.21%.Four joint inspections of Myo,cTnI,IL-6 and CRP don′t improve AMI sensitivity.cTnI is related to Myo,cTnI and hs-CRP,hs-CRP to IL-6,Myo and IL-6.As a conclusion,serum Myo,cTnI inspection has important effect on AMI early diagnosis.Serum Myo,cTnI inspection and IL-6,CRP combined inspection both have little significance on AMI diagnosing.