急性心肌梗死合并感染检测心肌梗死三项(肌钙蛋白、CK-MB、肌红蛋白)的临床价值

目的探讨急性心肌梗死合并肺部感染患者检测心肌梗死三项(肌钙蛋白、CK-MB、肌红蛋白)的应用价值,为临床诊断提供参考。方法选取我院收治的急性心肌梗死患者94例,根据患者是否并发肺部感染,将其分为感染组16例和未感染组78例。分别在入院时、发生肺部感染后(感染组)/入院48 h后(未感染组)、出院时检测患者的肌钙蛋白、CK-MB、肌红蛋白水平,对比两组患者3次检测的结果。结果两组患者第1次检测心肌梗死三项水平的对比,差异没有统计学意义(P>0.05);感染组第2次检测肌钙蛋白水平为(0.42±0.06)ng/mL,CM-MB水平为(8.30±0.38)ng/mL,肌红蛋白水平为(104.17±6.43)ng/mL,均显著高于第1次检测结果(P<0.05);而未感染组第2次检测的肌钙蛋白、CK-MB、肌红蛋白的水平均显著低于第1次检测结果(P<0.05);两组患者第3次检测的肌钙蛋白、CK-MB、肌红蛋白水平均显著低于第2次检测结果,而感染组第3次肌钙蛋白、CK-MB、肌红蛋白的检测结果显著高于未感染组(P<0.05)。结论肺部感染可使急性心肌梗死患者心肌梗死三项指标进一步升高,可能会影响临床医师对急性心肌梗死病情的判断,在临床诊疗时要注意鉴别。

The Clinic Value of Detection of CK-MB,Cardiac Troponin,Myoglobin on Patients with Acute Myocardial Infarction Complicated with Infection

Objective To study the acute myocardial infarction patients with pulmonary infection detection of myocardial infarction three （CK-MB, cardiac troponin, myoglobin） application value, provides the reference for the clinical diagnosis. Methods 94 patients with acute myocardial infarction in our hospital were selected, according to whether the patients complicated with pulmonary infection, divided into the infection group with 16 cases and non infection group with 78 cases. Pulmonary infection at the time of admission, respectively （infection group）/48 hours after admission （non infection group）, discharge monitoring in patients with troponin, myoglobin, CK-MB level, the results of the 3 test were compared between two groups. Results The second detection of troponin level was （0.42±0.06） ng/mL, CM-MB level was （8.30±0.38） ng/mL, myoglobin levels （104.17±6.43） ng/mL in infection group, they were significantly higher than that of the first test results （〈0.05）;while the uninfected group second detection of troponin, myoglobin, CK-MB levels were significantly lower than those of the first test results （〈0.05）;two patients third detection of troponin, myoglobin, CK-MB levels were significantly lower than the second test results, and the test results the infection group the third troponin CK-MB, myoglobin, was significantly higher than that in non infection group （〈0.05）. Conclusion Pulmonary infection can make three indexes in patients with acute myocardial infarction and myocardial infarction increased further, may affect the clinicians on acute myocardial infarction in the clinical diagnosis and treatment of the judge, should pay attention to identification.