电化学发光法测定血清标志物在急性心肌梗死中的诊断价值

摘要

Objective To discuss the value of early diagnosis with electrochemical luminescence method to detect the serum troponin T (cTnT), myoglobin (Mb), creatine kinase isoenzyme (CK-MB) in patients with acute myocardial infarction (AMI).Method The value of cTnT, Mb, CK-MB were respectively detected in 40 healthy cases as control group and 48 cases of patients with AMI as experimental group at two time points, within 6 h and 6~12 h after onset of chest pain. The sensitivity and specificity of three indicators were analyzed respectively. Result The value of cTnT are(0.31±0.06)ng/ml and(0.52±0.14) ng/ml in AMI ≤6h group and 6~12 h group respectively, which are significantly higher than that of the control group (0.01±0.00 ng/ml) (P< 0.01). The value of cTnT increases significantly (P< 0.01) as the time after the onset of chest pain goes. The value of Mb are(100.36±31.64)ng/ml and(161.39 ±35.51)ng/ml in AMI≤6h group and 6~12 h group respectively which are significantly higher than that of the control group (31.48±8.01)ng/ml (P< 0.01). The value of Mb increased by statistically significant (P< 0.01) as the time after the onset of chest pain goes. The value of CK-MB are(16.82±1.35)ng/ml and(40.14±2.32)ng/ml in AMI ≤6h group and 6~12 h group respectively which are significantly higher than that of the control group (2.01±0.51)ng/ml (P< 0.01). The value of CK-MB increases significantly (P< 0.01) as the time after the onset of chest pain goes. The sensitivity and specificity of cTnT are 95.64% and 98.56% which are higher than 92.68% and 84.56% of Mb and 81.63% and 83.69% of CK-MB.Conclusion Detection of cTnT, Mb, CK-MB using electrochemical luminescence method could diagnose AMI at early stage. The label of cTnT has the highest sensitivity and specificity in these three labels.%目的：探讨电化学发光法检测血清肌钙蛋白T（cTnT）、肌红蛋白（Mb）、肌酸激酶同工酶（CK-MB）在急性心肌梗死（acute myocardial infarction,AMI）患者中的诊断价值。方法分别对40例健康对照组和48例AMI组患者在胸痛发作后6小时内和6～12小时两个时段的cTnT、Mb、CK-MB进行测定，并统计三项检测指标的敏感性和特异性。结果AMI≤6小时组和6～12小时组cTnT分别为（0.31±0.06）ng/ml和（0.52±0.14）ng/ml，均比对照组（0.01±0.00 ng/ml）显著增高（P＜0.01），并随胸痛后时间增加而增加，二者差别有统计学显著意义（P＜0.01）。AMI≤6小时组和6～12小时组Mb分别为（100.36±31.64 ng/ml）和（161.39±35.51）ng/ml，均比对照组（31.48±8.01）ng/ml显著增高（P＜0.01），并随胸痛后时间增加而增加，二者差别有统计学显著意义（P＜0.01）。AMI≤6小时组和6～12小时组CK-MB分别为（16.82±1.35）ng/ml和（40.14±2.32）ng/ml，均比对照组（2.01±0.51）ng/ml显著增高（P＜0.01），并随着胸痛后时间增加而增加，二者差别有统计学显著意义（P＜0.01）。三项指标中cTnT的敏感性和特异性为95.64%和98.56%，分别高于Mb的92.68%和84.56%以及CK-MB的81.63%和83.69%。结论电化学发光法检测cTnT、Mb、CK-MB可以早期诊断AMI，其中cTnT的敏感性和特异性最高。