心型脂肪酸结合蛋白对急性心肌梗死的早期诊断价值

目的 探讨心型脂肪酸结合蛋白(H-FABP)、肌钙蛋白T(cTnT)和肌酸激酶同工酶(CK-MB)对急性心肌梗死(AMI)患者的早期诊断效率.方法 选取疑似AMI的患者,留取血浆并测定血浆H-FABP、cTnT和CK-MB值,根据发病时间分为0～6h、6～12h两组并进行分析.结果 在对AMI特别是在ST抬高心肌梗死(STAMI)的诊断上,H-FABP早期(0～6 h)诊断效率(0.883)明显高于cTnT(0.764)和CK-MB (0.838),灵敏度和特异度也较高(90.0％、74.0％);在cTnT阴性的患者特别是0～6h组中H-FABP的诊断效率、灵敏度和特异度都很高(0.929、84.0％、93.9％).结论 H-FABP作为心肌损伤的早期标志物,具有较高的诊断效率、灵敏度和特异度,是较为理想的AMI特别是STAMI的早期诊断指标.     

床旁快速检测心型脂肪酸结合蛋白在老年急性心肌梗死早期诊断中的价值

目的 采用床旁快速检测（POCT）心型脂肪酸结合蛋白（H-FABP）,探讨心型脂肪酸结合蛋白（H-FABP）、肌钙蛋白T（cTnT）、肌酸激酶同工酶（CK-MB）在急性心肌梗死患者（AMI）早期诊断中的价值.方法 选取因急性胸痛疑似ACS的老年患者,留取血浆并测定血浆H-FABP、cTnT、CK-MB值,根据发病时间分为0～6h、6～12 h和＞12 h组进行分析.结果 在AMI早期（0～6h）H-FABP诊断效率（0.913）高于cTnT（0.786）和CK-MB（0.742）,灵敏度和特异度也较高（78.62％、85.70％）,血浆H-FABP浓度高于不稳定心绞痛（UAP）组和对照组（P＜0.01）.结论 H-FABP在AMI发生的早期有较高的诊断效率、灵敏性和特异性,可以作为早期,特别是6h内诊断AMI的生化标记物.POCT快速检测试剂盒具有操作简便快捷,结果可靠等优点,适合在临床推广.     

心脏型脂肪酸结合蛋白在急性心肌梗死早期诊断中的价值

目前临床早期诊断急性心肌梗死(AMI)的指标主要有肌酸激酶(CK)、肌酸激酶异构酶(CK-MB)、肌钙蛋白I(TroponinI)、肌钙蛋白T(Troponin T)和肌红蛋白(Myoglobin)等。但CK-MB、肌钙蛋白I、肌钙蛋白T缺乏敏感性,它们在胸痛后6～8h浓度才上升;肌红蛋白则缺乏特异性,虽然在胸痛后2～3h浓度上升,但其不能区分骨骼肌和心肌损伤。近来Alhadi等〔1,2〕报道心脏型脂肪酸结合蛋白(h-FABP)在胸痛后2～3h后浓度开始上升,在4～8h内达到最高值,在12～24h内恢复到正常水平,且h-FABP的免疫性不同于其他类型的FABP,具有特异性,不会发生交叉反应,…     

心肌型脂肪酸结合蛋白在急性胸痛患者中的诊断价值

目的研究心肌型脂肪酸结合蛋白(H-FABP)对急性胸痛患者中的诊断价值,比较不同心脏标志物诊断AMI的价值。方法选择2010年10月至2012年6月因急性胸痛发作6h内就诊患者122例,即刻采肘静脉血5ml。采用快速检测试剂盒(胶体金法)检测H-FABP,同时测定肌钙蛋白T(cTnT)和肌酸激酶同工酶MB(CK-MB)。采用SPSS17.0软件比较3种心脏标志物在诊断急性心肌梗死(AMI)的灵敏度、特异度、阳性预测值和阴性预测值。结果在AMI发病6h内,H-FABP对AMI的诊断灵敏度及阴性预测值均高于cTnT和CK-MB,差异有统计学意义(P<0.01)。结论 H-FABP是目前早期(0~6h)诊断AMI比较敏感和准确的心脏生化标志物之一。     

床边快速肌钙蛋白T测定对急性胸痛患者诊断的价值

目的评价床边快速心肌肌钙蛋白T(cTnT)检测对以急性胸痛症状住院或转科的患者诊断的价值。方法采用床边快速心肌肌钙蛋白T测定仪(CARDIACREADER)测定502例以急性胸痛症状入院或转入心内科的患者入院即刻、6h、12h的cTnT水平,同时测定患者的心肌肌钙蛋白I(cTnI)、肌酸磷酸激酶(CK)及其同功酶(CK-MB)水平。以心电图出现急性心肌梗死(AMI)的动态改变和(或)CK-MB和TnI同时升高诊断为心肌梗死,计算床边快速cTnT诊断急性心肌梗死的特异性、敏感性、阴性预测价值和阳性预测价值。结果502例急性胸痛患者,cTnT阳性160例(31.9%),cTnT阴性323例(64.3%),19例弱阳性。139例cTnT阳性患者发生AMI,7例cTnT阴性的患者发生AMI。床边快速cTnT对以急性胸痛症状住院或转科的患者诊断AMI的特异性为93.8%、敏感性为95.2%、阳性预测价值为86.9%、阴性预测价值为97.8%。结论床边快速肌钙蛋白T测定可以迅速准确地在急性胸痛患者中识别或排除AMI患者,具有重要的诊断价值。     

ACS患者血栓前体蛋白检测的意义

目的:了解血浆血栓前体蛋白检测对急性冠状动脉综合征(ACS)的诊断价值.方法:采用酶联免疫吸附法将60例ACS患者根据临床症状分为急性心肌梗死(AMI)(AMI组,30例)和不稳定型心绞痛(UAP)(UAP组,30例)组.采用酶联免疫吸附法测定胸痛发作6 h内和24 h内血浆血栓前蛋白含量,肌钙蛋白T(cTnT)测定采...     

心脏脂肪酸结合蛋白水平对急性冠脉综合征的早期诊断

目的研究心脏脂肪酸结合蛋白对急性冠脉综合征(ACS)的早期诊断意义。方法以174例胸痛患者为研究对象,根据ACS类型分为急性心肌梗死(AMI)组和不稳定型心绞痛(UA)组。在患者入院后0 h、3 h、6 h、12 h和24 h分别测定心脏脂肪酸结合蛋白(H-FABP)水平,采用统计学方法分析H-FABP诊断ACS的准确性。结果 AMI组入院后0、3、6、12和24 h的血清H-FABP和肌钙蛋白(cTn)I水平均存在显著性差异(均P<0.001)。0 h、3 h、6 h的H-FABP阳性率明显高于cTnI阳性率,而12 h和24 h的H-FABP阳性率却显著低于cTnI阳性率。结论 H-FABP可以用于ACS患者的早期诊断。     

心肌型脂肪酸结合蛋白检测在急性心肌梗死早期诊断中的应用

目的:探讨心肌型脂肪酸结合蛋白(H-FABP)在急性心肌梗死(AMI)早期诊断中的应用价值.方法:选择110例因急性胸痛住院的患者,按胸痛发作时间到就诊时间先后分为＜3 h、3～6 h和＞6 h三组,检测各组H-FABP、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)水平变化,比较3种心肌标志物诊断早期AMI的敏感性、特异性、阳性预测值、阴性预测值,同时比较胸痛发作≤6h时不同心肌标志物联合诊断AMI的敏感性、特异性、阳性预测值、阴性预测值.结果:入选病例最终确诊为AMI 62例,非AMI 48例(其中不稳定型心绞痛20例,稳定型心绞痛18例,非心源性胸痛10例).＜3 h组H-FABP、CK-MB、cTnI水平诊断AMI的敏感性分别为87.5％、9.1％、45.8％;特异性分别为83.3％、91.6％、91.6％;3～6 h组H-FABP、CK-MB、cTnI水平诊断AMI的敏感性分别为98.1％、54.5％、63.6％;特异性分别为94.4％、88.9％、93.7％;＞6 h组H-FABP、CK-MB、cTnI水平诊断AMI的敏感性分别为81.3％、93.7％、75.0％;特异性分别为83.3％、94.4％、100％;3种检测指标的特异性、阴性预测值、阳性预测值差异无统计学意义(P＞0.05);胸痛发作≤6h时H-FABP与cTnI联合检测诊断AMI的敏感性为93.5％、特异性为85.4％,cTnI与CK-MB联合检测诊断AMI的敏感性为74.1％、特异性为87.5％.结论:H-FABP水平检测对于早期诊断AMI有较高的敏感性,优于传统指标CK-MB、cTnI,但特异性、阳性预测值、阴性预测值与CK-MB、cTnI相当.胸痛发作≤6h时H-FABP与cTnI联合检测可进一步提高AMI早期诊断的敏感度,优于传统的cTnI与CK-MB联合检测.     

急性冠脉综合征患者CK-MB、cTnT及CRP水平变化与临床意义

目的 分析急性冠脉综合征(ACS)患者肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白T(cTnT)及C反应蛋白(CRP)水平变化及其临床意义.方法 选取2017年1月-2018年5月本院接收的96例ACS患者(研究组)临床资料,根据GRACS评分将ACS患者分为低危组(n=34)、中危组(n=32)和高危组(n=30).同...     

心型脂肪酸结合蛋白与急性心肌梗死预后的关系

<正>急性心肌梗死(AMI)患者得到迅速明确的诊断及及早治疗能够显著降低死亡率,改善预后〔1〕。心型脂肪酸结合蛋白(H-FABP)在心肌坏死情况下早期迅速释放,已有研究表明,HFABP在心肌梗死患者体内3 h即达到最高峰〔2〕,与肌钙蛋白(cTnT)、肌酸激酶同工酶(CK-MB)相比,升高时间更早〔3〕,表明H-FABP对诊断AMI的早期诊断有较高的敏感性和特异性。     

Heart-type fatty acid binding protein--a reliable marker of myocardial necrosis in a heterogeneous group of patients with acute coronary syndrome without persistent ST elevation

BACKGROUND: Myocardial infarction (MI) is one of the most serious challenges of contemporary cardiology. Among biochemical markers, heart-type specific fatty acid binding protein (h-FABP) has a high potential as a marker for the early diagnosis of acute MI. The h-FABP is released early to the bloodstream and may be useful for both rapid confirmation and exclusion of infarction. As opposed to patients with ST segment elevation MI (STEMI), patients with unstable angina (UA)/non-ST segment elevation MI (NSTEMI) present a heterogeneous group in which the confirmation of MI often meets diagnostic difficulties. A rapid, qualitative immunoenzymatic 'point of care' type test, revealing h-FABP in blood, has recently been made available (CardioDetect med). AIM: To evaluate diagnostic value of early measurements of h-FABP and other markers of necrosis (cTnT, CK-MB, CK-MB mass) in a group of 100 patients with an acute coronary syndrome (ACS) without persistent ST segment elevation (NSTE ACS). METHODS: We studied 100 consecutive patients (34 women, 66 men; mean age 61.6 years) with strong suspicion of NSTE ACS and chest pain lasting <24 h before admission. During admission and after 3 and 6 hours patients had measured a panel of conventional biomarkers as well as quantitative measurements of h-FABP (on admission and 3 hours later) using CardioDetect med. The ultimate diagnosis of infarction (NSTEMI) was confirmed in case of a second (6 h after admission) positive quantitative result of cardiac troponin. Non-ST segment elevation MI was finally diagnosed in 56 patients. RESULTS: The comparison of diagnostic utility of all analysed biomarkers of necrosis revealed that h-FABP was superior to other parameters, when measured on admission, and was characterised by 94.7% sensitivity, 100% specificity, 100% positive predictive value, 93.4% negative predictive value and 97% accuracy. Other biomarkers had on admission lower sensitivity - 70.1% for CK-MB mass, 66.7% for CK-MB, 64.9% for cTnT, whereas their specificity was 97.6% for CK-MB mass, 93% for CK-MB and 100% for cTnT. CONCLUSIONS: Qualitative h-FABP test (CardioDetect med) showed excellent sensitivity, higher than measurements of CK-MB mass, CK-MB, and cTnT on hospital admission, and high specificity in the patient group with NSTE ACS. The h-FABP seems to be an excellent biochemical cardiac marker for diagnosing NSTEMI, especially in its early phase, allowing exclusion of myocardial necrosis.     

cTnT在判断急性心肌梗死及不稳定型心绞痛预后中的价值

目的 :探讨心肌肌钙蛋白 T（c Tn T）对急性心肌梗死 （AMI）诊断及评估不稳定型心绞痛 （U AP）预后的临床价值。方法 :对 76例胸痛患者进行入院即刻血浆 c Tn T半定量、同步心肌酶学定量测定 ,观察对比 c Tn T与心肌酶学在诊断 AMI及评估 U AP患者预后中的特异性和敏感性。结果 :76例胸痛患者中 AMI 34例、U AP 2 7例、稳定劳力性心绞痛 8例、其它胸痛疾患 7例。AMI34例 c Tn T全部阳性 ,而 U AP2 3例和其余病例 c Tn T均为阴性。AMI患者同步 CK,AST升高者 2 8例 ,L DH升高者 30例。c Tn T与心肌酶学差异未达显著水平 （P>0 .0 5 ） ,但发病 2～ 5 h者 10例 ,心肌酶各项均正常 ,与 c Tn T对比有高度显著性差异 （P<0 .0 1） ;发病 5～ 11d者 6例 ,仅 2例 L DH还表现出升高外 ,其余心肌酶均正常 ,与 c Tn T对比有显著性差异 （P<0 .0 5 ） ;发病 5～ 12 0 h者相差均不显著 （P>0 .0 5 ）。在 2 7例 U AP患者中 ,c Tn T阳性组 AMI和难治性心绞痛发生率显著高于 c Tn T阴性组 （P<0 .0 1） ;c Tn T阴性组药物疗效好 ,近期心脏事件发生率低 ,与 c Tn T阳性组对比亦有高度显著性差异 （P<0 .0 1）。结论 :c Tn T是反映心肌细胞损伤灵敏性、特异性均较好的生化指标 ;c Tn T对诊断早期和晚期 AMI的价值高于心肌酶学 ;c Tn T阳性     

Prognostic value of a qualitative test for heart-type fatty acid-binding protein in patients with acute coronary syndrome

Heart-type fatty acid-binding protein (h-FABP) is a novel diagnostic marker for myocardial infarction, but its prognostic value has not been established in patients with acute coronary syndrome (ACS). We sought to determine the value of qualitative analysis of h-FABP for predicting 30-day adverse events in patients with ACS. A retrospective observational study was conducted on patients at a community hospital, and 130 patients admitted through the emergency room (ER) for ACS were identified among 12,077 patients who presented to the ER between January and June 2003. Of these 130 patients, 90 (mean age, 66.8 years, 67 males) who had ACS were eligible for this study. Qualitative tests for serum h-FABP and troponin T (cTnT) were performed on presentation. Follow-up information on adverse events within 30 days after admission, defined as cardiac death or recurrent ACS, was obtained from the medical records. The qualitative tests for h-FABP and troponin T were positive in 62.2% and 36.7%, respectively. The cumulative adverse event rate at 30 days was 14.8% in the h-FABP-positive group and 3.2% in the negative group. The adjusted relative risk of a positive h-FABP test for adverse events was 44.98 (95% CI: 1.48 to 1,364.88). A positive h-FABP test was an independent predictor of adverse events within 30 days in these patients.     

Diagnostic accuracy of cardiac markers for myocardial damage after radiofrequency catheter ablation

Aims This study compares serum markers of myocardial damage incurred during radiofrequency catheter ablation (RFCA). Methods and results Blood was sampled from 34 patients with atrial flutter (n = 16), atrioventricular nodal reentrant tachycardia (AVNRT; n = 13), and Wolff–Parkinson–White syndrome (WPW; n = 5) to measure creatine kinase MB subfraction (CK-MB), human heart-type fatty acid protein (h-FABP), and cardiac troponin T (cTnT) values at baseline and after RFCA. The controls comprised 12 patients without significant elevation of all myocardial markers during electrophysiological study (EPS) without RFCA. h-FABP values did not elevate significantly, whereas CK-MB and cTnT demonstrated significant change after RFCA (P < 0.001). Neither peak h-FABP nor CK-MB correlated with following RFCA parameters: delivery duration, number of RFCA discharges, and cumulative RFCA energy. In contrast, correlations were significant between mean peak values of cTnT and these RFCA parameters (all P < 0.05). The sensitivity (71.6%) and specificity (35.6%) of h-FABP were inferior to those of cTnT (93.3% and 89.8%, respectively). Conclusion h-FABP is an insensitive and less specific marker of myocardial damage in RFCA much along the lines of CK-MB and when compared with the proven accuracy of cTnT.     

妊娠期高血压疾病患者血清NT-proBNP及h-FABP水平变化及其临床意义

目的 探讨妊娠期高血压疾病(HDCP)患者血清N末端B型钠尿肽原(NT-proBNP)及心脏型脂肪酸结合蛋白(h-FABP)水平变化及其临床意义.方法 选择我院HDCP患者116例为HDCP组,正常晚孕妇女30例为正常晚孕组,体检健康的无孕妇女35例为正常非孕组,分别采用电化学发光免疫分析(ECLIA)法及双抗体夹心酶联免疫一步(ELISA)法,定量检测3组的血清NT-proBNP及h-FABP水平.结果 正常晚孕组和HDCP组血清NT-proBNP及h-FABP水平均显著高于正常非孕组(P＜0.01),HDCP组显著高于正常晚孕组(P＜0.01),中重度HDCP组显著高于轻度HDCP组(P＜0.01);HDCP患者血清NT-proBNP阳性率(30.17%)显著低于血清h-FABP的阳性率(50.86%)(P＜0.01),且两者具有相关一致性.结论 HDCP患者存在血清NT-proBNP及h-FABP水平增高,联合检测血清NT-proBNP及h-FABP水平可及时了解HDCP患者早期心肌细胞损害及心脏功能情况,对指导治疗及改善预后具有重要意义.     

心肌型脂肪酸结合蛋白对心外科围术期心肌缺血与损伤的预测价值

目的 通过观察冠状动脉旁路移植术和室间隔缺损修补术围手术期不同时间人类心肌型脂肪酸结合蛋白(h-FABP)的动态变化,评价h-FABP在术中对心肌缺血及损伤的预测作用.方法 随机选取2008年2月至12月行冠状动脉旁路移植术和室间隔缺损修补术者各30例,分别于术前、主动脉夹闭时及主动脉开放后10 min、2 h.6 h、12 h、24 h取静脉血,检测h-FABP、缺血修饰白蛋白(IMA)、心肌肌钙蛋白I(cTnI)和肌酸激酶同工酶(CK-MB)的含量.结果 h-FABP与IMA变化趋势一致.h-FABP与cTnI和CK-MB变化趋势相似,但是h-FABP在心肌缺血与损伤后血中高峰时间出现得更早,维持时间较短,在2 h后即明显下降,24 h回复基线水平.经线性相关分析,冠状动脉旁路移植术组h-FABP的峰值与IMA、CK-MB和cTnI的峰值高度呈正相关(P<0.05),相关系数r分别为0.948、0.964和0.961.室间隔缺损修补术组有类似的结果,h-FABP的峰值与IMA、CK-MB和cTnI的峰值高度呈正相关(P<0.01),相关系数r分别为0.986、0.978和0.957.结论 h-FABP是心外科围手术期心肌缺血和损伤的早期诊断指标.h-FABP血中水平的定量监测可以有效地预测术中心肌缺血与损伤情况.     

心肌型脂肪酸结合蛋白对心外科围术期心肌缺血与损伤的预测价值

目的 通过观察冠状动脉旁路移植术和室间隔缺损修补术围手术期不同时间人类心肌型脂肪酸结合蛋白(h-FABP)的动态变化,评价h-FABP在术中对心肌缺血及损伤的预测作用.方法 随机选取2008年2月至12月行冠状动脉旁路移植术和室间隔缺损修补术者各30例,分别于术前、主动脉夹闭时及主动脉开放后10 min、2 h.6 h、12 h、24 h取静脉血,检测h-FABP、缺血修饰白蛋白(IMA)、心肌肌钙蛋白I(cTnI)和肌酸激酶同工酶(CK-MB)的含量.结果 h-FABP与IMA变化趋势一致.h-FABP与cTnI和CK-MB变化趋势相似,但是h-FABP在心肌缺血与损伤后血中高峰时间出现得更早,维持时间较短,在2 h后即明显下降,24 h回复基线水平.经线性相关分析,冠状动脉旁路移植术组h-FABP的峰值与IMA、CK-MB和cTnI的峰值高度呈正相关(P<0.05),相关系数r分别为0.948、0.964和0.961.室间隔缺损修补术组有类似的结果,h-FABP的峰值与IMA、CK-MB和cTnI的峰值高度呈正相关(P<0.01),相关系数r分别为0.986、0.978和0.957.结论 h-FABP是心外科围手术期心肌缺血和损伤的早期诊断指标.h-FABP血中水平的定量监测可以有效地预测术中心肌缺血与损伤情况.     

心肌型脂肪酸结合蛋白对心外科围术期心肌缺血与损伤的预测价值

目的 通过观察冠状动脉旁路移植术和室间隔缺损修补术围手术期不同时间人类心肌型脂肪酸结合蛋白(h-FABP)的动态变化,评价h-FABP在术中对心肌缺血及损伤的预测作用.方法 随机选取2008年2月至12月行冠状动脉旁路移植术和室间隔缺损修补术者各30例,分别于术前、主动脉夹闭时及主动脉开放后10 min、2 h.6 h、12 h、24 h取静脉血,检测h-FABP、缺血修饰白蛋白(IMA)、心肌肌钙蛋白I(cTnI)和肌酸激酶同工酶(CK-MB)的含量.结果 h-FABP与IMA变化趋势一致.h-FABP与cTnI和CK-MB变化趋势相似,但是h-FABP在心肌缺血与损伤后血中高峰时间出现得更早,维持时间较短,在2 h后即明显下降,24 h回复基线水平.经线性相关分析,冠状动脉旁路移植术组h-FABP的峰值与IMA、CK-MB和cTnI的峰值高度呈正相关(P<0.05),相关系数r分别为0.948、0.964和0.961.室间隔缺损修补术组有类似的结果,h-FABP的峰值与IMA、CK-MB和cTnI的峰值高度呈正相关(P<0.01),相关系数r分别为0.986、0.978和0.957.结论 h-FABP是心外科围手术期心肌缺血和损伤的早期诊断指标.h-FABP血中水平的定量监测可以有效地预测术中心肌缺血与损伤情况.     

Elevated homocysteine levels are associated with increased ischemic myocardial injury in acute coronary syndromes

OBJECTIVES: This study was conducted to determine whether the amount of myocardial damage during acute coronary syndromes (ACS) is related to the admission plasma homocysteine concentration. BACKGROUND: Elevated homocysteine levels are associated with increased thrombosis in patients presenting with ACS. It is not known whether this association is reflected in the degree of myocardial injury in those patients. METHODS: We studied consecutive patients presenting with acute myocardial infarction (MI) (n = 205) and unstable angina pectoris (UAP) (n = 185). Plasma samples were collected on admission and prior to clinical intervention and were assayed for homocysteine by high performance liquid chromatography (HPLC). Myocardial necrosis was assessed by measurements of cardiac troponin T (cTnT) on admission and 12 h after admission (peak cTnT). The patients were studied by quintiles of homocysteine concentration. RESULTS: There was a significant increase in peak cTnT in the 5th homocysteine quintile in MI (analysis of variance [ANOVA], p = 0.005), the levels being 4.10, 3.86, 4.13, 6.20 and 7.85 microg/liter for quintiles 1 to 5, respectively (p < 0.0001, for top vs. bottom quintile). Similarly, there was a step-up in peak cTnT levels in the top homocysteine quintile in UAP (ANOVA, p < 0.0001), the levels being 0.03, 0.03, 0.02, 0.04 and 0.15 microg/liter, (p < 0.0001 for top vs. bottom quintile). In a multivariate regression model, the association between peak cTnT and the top homocysteine quintile remained strong after adjustment of other confounders including age, gender, final diagnosis and thrombolysis treatment (odds ratio [OR]: 2.92 (1.75-4.87) p < 0.0001). The patients with UAP were further examined according to peak cTnT levels below (cTnT negative) or above (cTnT positive) 0.1 microg/liter. Homocysteine levels were significantly higher in cTnT positive than cTnT negative patients; 13.8 (11.7-15.3) vs. 10.3 (9.4-11.3) micromol/liter, respectively, p = 0.002. CONCLUSIONS: Elevated homocysteine levels are associated with a higher risk of ischemic myocardial injury in patients presenting with ACS.     

肌红蛋白、肌钙蛋白T、肌酸激酶同工酶的检测对老年急性心肌梗死溶栓再通的判定价值

目的　探讨血清肌红蛋白 (Mb)、肌钙蛋白T(cTnT)和肌酸激酶同工酶 (CK MB)对老年急性心肌梗死溶栓疗效的早期判定价值。方法　应用酶联免疫分析法测定 32例老年急性心肌梗死患者溶栓治疗后的Mb、cTnT、CK MB浓度 ,分析急性心肌梗死患者溶栓再通组 ( 1 8例 )和溶栓未通组 ( 1 4例 )上述指标的变化。结果　急性心肌梗死溶栓再通组Mb、cTnT和CK MB达到峰值浓度的时间明显较未通组提前 ( P <0 .0 5) ,其中Mb较cTnT和CK MB峰值出现更早 ,分别为( 7.4± 2 .5)h、( 1 3.7± 4.1 )h和 ( 1 4.4± 2 .7)h (P <0 .0 1 ) ;Mb的诊断敏感性 ( 79% )与诊断效率( 87% )明显高于cTnT( 6 0 %、75% )和CK MB( 47%、6 7% ) (P <0 .0 1 )。结论　血清Mb、cTnT和CK MB水平及其变化可以较好地早期预测急性心肌梗死患者溶栓再通 ,其中Mb较cTnT及CK MB具有更好的的临床价值。