心肌损伤标志物的测定在急性心肌梗死中的临床应用

目的：对心肌肌钙蛋白I（cTnI）、肌酸激酶同工酶（CK—MB）和肌红蛋白（Mb）进行定量分析比较，对急性心肌梗死（AMI）的早期诊断和风险预测提供较为可靠的检测指标。方法：对85例急性冠状动脉综合征患者（ACS）在入院后24h内检测cTnI、CK—MB和Mb的质量水平，探讨它们对AMI的敏感性和特异性，并进行评估。结果：患者入院后24h内cTnI、CK—MB和Mb对AMI的敏感性分别为93．3％，86．7％和78．3％，特异性分别为100％，100％和88．0％；同时检测cTnI和Mb时AMI的敏感性为96．7％，特异性为88．0％；同时检测cTnI、Mb和CK—MB时AMI的敏感性为98．3％，特异性为88．0％，阳性预期值为95．2％，阴性预期值为88．0％。结论：cTnI、CK—MB和Mb联合检测对诊断AMI具有高度的敏感性和特异性，而且cTnI可作为评估发生因心血管死亡事件的独立风险因子。

Clinical application of detection of myocardial injury markers in acute myocardial infarction

Objective: Quantitative analysis was performed for cardiac troponin I(cTnI) ,creatine kinase(CK-MB) and myocardial myohemoglohin (Mb) so as to provide available detective index in the early diagnosis of acute myocardial infraction(AMI)and risk prediction. Methods: Mass of serum cTnI,CK-MB and Mb of 85 patients with acute coronary artery syndrome(ACS) were detected within 24h to discuss their sensitivity and specificity to AMI. Results:The spective sensitivity value of cTnI,CK-MB and Mb were 93.3% ,86.7% and 78.3% ; the spective specificity value were 100%, 100% and 88.0% ;the sensitivity and specificity value of both cTnI and Mb were 96.7% and 88.0%; the sensitivity and specificity value of all cTnI, Mb and CK-MB were 98.3% and 88.0%;the positive and negative expectative value were 95.2% and 88.0%. Conclusions.. To AMI, there was most sensitive and specific to detect all of cTnl, CK-MB and Mb. cTnI was the individual risk factor by evaluating death occurrence for cardiovascular.