心脏标志物检测在心脏病诊断中的意义

目的观察冠心病和肺心病病人血清心脏标志物浓度的变化，探讨其在上述疾病中诊断和鉴别诊断的意义。方法将收治的冠心病人195例分为A组，肺心病病人79例分为B组；又将195例冠心病病人中前壁心肌梗塞80例分为C组，39例下壁心肌梗塞分为D组，76例心绞痛分为E组。分另q测定其血清肌钙蛋白I（TnI）、肌红蛋白（MYO）、肌酸激酶一同工酶（CK-MB）浓度。结果肺心病病人少部分MYO、CK—MB轻度升高外，其余在参考值范围；冠心病例3种标志物有不同程度升高。两组经非参数检验（P〈0．01），有统计学意义。在冠心病病例中心肌梗塞组和心绞痛组的对比、心肌梗塞中前壁梗塞和下壁梗塞的对比，3种标志物升高程度不一，经配对非参数检验（P〈0．01），皆有统计学意义。结论3种标志物检测对于冠心病的诊断、分型、危险分层和治疗及与肺心病的鉴别诊断有重要意义。

The significance of detecting the heart markers for diagnosis and differential diagnosis of coronary atherosclerotic heart disease and pulmonary heart disease

Objective To investigate the significance of detecting serum heart markers in patients with coronary atherosclerotic heart disease and pulmonary heart disease. Methods There were totally 274 patients divided into Group A consisted of 195 patients with coronary heart disease and Group B consisted of 79 patients with pulmonary heart disease. While the 195 cases in Group A were again divided into Group C consisted of 80 patients with forward wall myocardial infarction, Group D consisted of 39 patients with below wall myocardial infarction and Group E consisted of 76 patients with angina. The concentration of TnI, MYO and CK-MB in serum all cases were measured. Results The concentration of MYO,CK-MB in the cases were normal in most of the cases with pulmonary heart disease and a little higher in a few cases. The concentration of TnI,MYO and CK-Mb were increased at various extent in patients with coronary atherosclerotic heart disease, showing significant difference between Group A and B (P<0.01). There were also significant differences in the increase of three markers between Group C,D and E after comparison (P<0.01). Conclusion The detection of the three markers is of important significance in diagnosis and differentiating diagnosis of coronary atherosclerotic heart disease and pulmonary heart disease.