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1.
分别用固相免疫层析法和ELISA方法动态测定病毒性心肌炎组(VM,n=102)、病毒感染组(VI,n=41)和对照组(n=46)的血清肌钙蛋白I(cTnI)和柯萨奇病毒特异性抗体(CBV-IgM、IgG).结果①VM组cTnI阳性率70.58%,其中急性期阳性率达到87.93%,明显高于普通心肌酶CK、CK-MB和LDH的15.69%(P<0.01),而VI组与对照组无1例出现cTnI或心肌酶阳性.②VM组CBV-IgM阳性率(67.65%)明显高于VI组(17.07%),P<0.05.③在VM组中,IgM阳性者的cTnI阳性率(73.91%)明显高于IgG阳性者的cTnI阳性率(43.75%),P<0.01;cTnI阳性者中IgM阳性率(83.33%)也明显高于IgG阳性率(41.67%),P<0.01;而VM组中cTnI阴性者IgM阳性率(30.00%)明显低于IgG阳性率(60.00%),P<0.05.说明cTnI对VM的心肌损伤具有良好的敏感性、特异性和准确性,明显优于普通心肌酶,对VM急性期心肌损伤的敏感性更高.测定CBV-IgM、IgG有助于VM常见病因和病期的诊断.cTnI和CBV-Ig联合测定可使VM的诊断变得简单和成熟.  相似文献   

2.
目的观察心肌酶谱(AST、LDH、CK、CK—MB、HBDH)和肌钙蛋白I(cTnI)联合检测在急性心肌梗死(AMI)早期的临床诊断价值。方法对2010年9月至2011年3月来我院就诊的105例经确诊(符合WHO制定的诊断标准)的AMI患者进行心肌酶谱和cTnI联合检测,观察其对早期AMI诊断的特异性和敏感性。结果105例经确诊的AMI患者中,93例心肌酶改变,敏感性为88.6%;100例出现cTnI升高,敏感性为95.2%。100名健康对照者中,11例心肌酶发生改变,特异性为89%;1例cTnI升高,特异性为99%。结论心肌酶谱和cTnI联合检测在AMI早期的临床诊断中有重要价值。  相似文献   

3.
目的 探讨心血管疾病中心肌肌钙蛋白I(cTnI)的临床应用价值.方法 选取我院2009年3月-2011年5月收治的96例急性心肌梗死患者(AMI)作为观察组,以我院体检的80例健康体检者作为对照组.对照组体检时空腹抽取静脉血;AMI组于发病后4 h取血,以后每4 h取血1次,24 h后每天取血1次,直至7 d.采用自动化学发光分析仪检测心肌肌钙蛋白I(cTnI)、肌红蛋白(Myo)以及肌酸激酶同工酶(CK-MB)三项指标,比较这3项指标对AMI诊断的敏感性和特异性.结果 AMI组的cTnI、Myo以及CK-MB水平明显高于对照组(P<0.05),cTnI、Myo、CK-MB对AMI的敏感性分别为98.7%、90.0%、80.0%;特异性分别为96.9%、85.4%、94.8%.结论 急性AMI患者的cTnI、MB、CK-MB的值均明显升高,3项指标对AMI均有较高的灵敏度和特异性,其中以cTnI最佳.  相似文献   

4.
心肌脂肪酸结合蛋白对早期急性心肌梗死的诊断   总被引:9,自引:1,他引:8  
目的研究血浆心肌脂肪酸结合蛋白(HFABP)在早期急性心肌梗死(AMI)诊断中的价值。方法选择93例发病6h内的胸痛患者,其中AMI组32例,非AMI组61例[含不稳定型心绞痛(UAP)24例,稳定型心绞痛(SAP)者22例,非心源性胸痛者15例];正常对照组选择69例正常人。采用双抗体夹心酶联免疫一步法检测正常人和患者发病0~3h或3~6h血浆的HFABP含量,并与心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CKMB)和肌红蛋白(MYO)的检测结果进行比较,分析4种生化标志物诊断发病3h内和6h内AMI的敏感性、特异性和准确性。结果在0~3h、0~6h时间段,HFABP诊断AMI的敏感性(64.29%、84.38%)显著高于cTnI(28.57%、53.13%)和CKMB(21.43%、56.25%),与MYO(71.43%、78.13%)比较差异无统计学意义;在诊断特异性上,4种生化标志物差异无统计学意义;在诊断准确性上,HFABP的ROC曲线下面积(0.979、0.958)显著高于cTnI(0.800、0.878)、CKMB(0.575、0.782)和MYO(0.796、0.882)。结论HFABP对于诊断早期AMI具有较高的敏感性和良好的特异性,其诊断准确性优于cTnI、CKMB、MYO。  相似文献   

5.
目的探讨手足口病(HFMD)患儿伴发心肌损害所致心肌酶、心电图及cTnI异常表现。方法对180例确诊患儿和我院同期住院的小儿外科患儿100例同时于入院次日和病程结束后,行心肌酶谱、心电图和cTnI检查。结果①HFMD患儿与正常小儿比较心肌酶谱明显升高(P〈0.01);②HFMD患儿心电图异常率71.3%,以ST-T改变为主;③HFMD患儿cTnI异常44例(占24.4%);④心肌酶谱、cTnI、心电图三者具有相关性。结论部分HFMD患儿伴发心肌损害时心肌酶谱和cTnI明显升高,心电图出现异常改变。早期进行心肌酶学、cTnI和心电图等检测,有助于HFMD患儿心肌损害的早期诊断和治疗。  相似文献   

6.
目的探讨心肌肌钙蛋白I(cTnI)在小儿病毒性心肌炎中的诊断价值。方法检测62例小儿病毒性心肌炎的血清cTnI、肌酸激酶同工酶(CK-MB)水平,并对诊断心肌炎阳性率进行比较。结果血清cTnI诊断心肌炎阳性率明显高于CK-MB,差异有统计学意义(P<0.01)。62例患儿心电图表现:心律失常者24例(38.7%),ST段改变者21例(33.9%),房室传导阻滞者10例(16.13%),P波改变者5例(8.1%),束支传导阻滞者2例(3.2%)。结论 cTnI对于诊断小儿病毒性心肌炎有较高的敏感性和特异性,可作为小儿病毒性心肌炎早期诊断的可靠指标。  相似文献   

7.
目的:探讨床边快检心肌肌钙蛋白I(cTnI)、肌红蛋白(Mb)在急性心肌梗塞(AMI)早期诊断中的应用以及二项之间的相互关系。方法:选择96例疑似ACS患者的血液标本,在不同时段,同时进行cTnI和Mb的测定。结果:在确诊的87例AMI早期诊断中,cTnI阳性出现滞后,3h内测定的阳性率为16.1%,显著低于Mb的阳性率(72.4%),P<0.01;24h内测定cTnI的阳性率为100%。结论:在急诊科床边快检cTnI与Mb对AMI的早期诊断非常必要,可起到优势互补的作用。  相似文献   

8.
目的分析老年急性心肌梗死(AMI)患者血清中心肌损伤标志物肌钙蛋白(cTnI)及肌酸激酶同工酶(CK-MB)表达及水平变化情况,探讨cTnI、CK-MB及超声心动图检测对老年AMI的诊断价值。方法选取老年AMI患者60例作为观察组,另纳入同期接受治疗的不稳定性心绞痛老年患者60例作为对照组,两者均采用超声心动图检测,比较两组血清心肌损伤标志物cTnI及CK-MB表达及水平变化。结果观察组血清cTnI、CK-MB水平显著高于对照组(P <0. 05);以0. 997 pg/L为截点值,cTnI诊断老年AMI的敏感性为85. 00%,特异性为88. 33%;以42. 573 U/L为截点值,CK-MB诊断老年AMI的敏感性为75. 00%,特异性为76. 67%; cTnI联合超声心动图诊断老年AMI的敏感性为96. 67%,特异性为75. 00%,与单项cTnI及超声心动图诊断价值比较,差异均有统计学意义(P<0. 05)。结论血清cTnI联合超声心动图检测可显著提高对老年AMI心肌梗死的诊断率,减少漏诊率。  相似文献   

9.
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.  相似文献   

10.
目的探讨血清和肽素、循环微小RNA-1对于急性心肌梗死(AMI)的临床鉴别诊断价值。方法选取2017年1月—2017年8月三门峡市中心医院收治的100例胸痛病人,根据最终临床确诊将病人分为AMI组(57例)、非AMI组(43例),对比两组入院时的血清和肽素、循环微小RNA-1水平及心肌酶学指标,绘制受试者工作曲线(ROC)求取最佳诊断临界值对应的诊断学指标。结果 AMI组血清三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)均高于非AMI组(P0.05),高密度脂蛋白胆固醇(HDL-C)低于非AMI组(P0.05);AMI组病人的血清肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)及血清和肽素、循环微小RNA-1水平均高于非AMI组(P0.05);血清和肽素、循环微小RNA-1联合检测对于鉴别诊断AMI的灵敏度为97.73%,特异度为93.48%,漏诊率为2.27%,误诊率为6.52%,ROC曲线下面积AUC值为0.949。结论血清和肽素、循环微小RNA-1对于鉴别诊断AMI具有较高的敏感性。  相似文献   

11.
急性冠状动脉综合征患者血清IL-10及IL-12水平测定   总被引:4,自引:0,他引:4  
目的 :探讨白细胞介素 - 10 (IL- 10 )、白细胞介素 - 12 (IL- 12 )对动脉粥样硬化 (AS)形成和发展的影响。方法 :分别对 18例急性心肌梗死 (AMI)患者于发病当天及第 3,5 ,7,10 ,14天 ;14例不稳定型心绞痛 (UAP)患者及 10例健康对照者测定血清 IL - 10、IL - 12水平。结果 :1U AP患者 IL - 10、IL - 12水平显著高于对照组。 2A MI患者血清 IL - 10于发病当天至第 5天显著高于其他两组 ,并于第 3天达高峰。 IL - 12于发作当天及第 10~ 14天显著高于对照组。3AMI死亡组 IL - 10水平明显高于生存组 ,而 IL - 12无显著性差异。结论 :提示急性冠状动脉事件患者 IL - 10、IL - 12升高 ,二者可能参与了 A S的形成和发展 ,并可作为急性期预测指标。  相似文献   

12.
目的 观察不稳定型心绞痛患者 (UA)入院后血清肌钙蛋白 I(c Tn I)和肌红蛋白 (Mb)变化 ,探讨其与心电图(ECG)改变、心绞痛分级、冠状动脉病变的关系及对心脏事件的近期、远期预报价值。方法  6 0例 U A患者分别在入院、入院后 12 h、2 4 h、4 8h、10 d各采血一次。用免疫发光法 (IMMU L ITE系统 )测定 c Tn I、Mb和肌酸激酶同工酶 (CK- MB)浓度 ,分析其与心脏事件的关系。结果 在近期 (30 d)内 ,c Tn I≥ 0 .4 ng/ m l组与 c Tn I<0 .4 ng/ m l组心脏事件发生率分别为 4 8.15 %和 9.1% (P<0 .0 5 )。入院时 Mb≥ 2 5 ng/ ml组与 Mb<2 5 ng/ ml组心脏事件发生率分别为 4 5 .4 5 %和 15 .79% (P<0 .0 5 )。 c Tn I对预测近期发生心脏事件的敏感性 81.2 5 %、特异性 6 8.18%、阳性预测值 4 8.15 %、阴性预测值 90 .90 %、准确性 71.6 7%。 Mb对预测近期发生心脏事件的敏感性 6 8.75 %、特异性4 7.7%、阳性预测值 33.33%、阴性预测值 82 .14 %、准确性 5 6 .6 7%。远期 :c Tn I≥ .0 4 ng/ m l组死亡率为 18.5 2 %(5 / 2 7) ;c Tn I<0 .4 ng/ ml组死亡率为 3.0 3% (1/ 33) ;(P<0 .0 5 )。Mb≥ 2 5 ng/ ml组死亡率为 12 .5 0 % (4 / 32 ) ;Mb<2 5 ng/ ml组死亡率为 7.14 % (2 / 2 8) ;(P>0 .0 5 )。结论  相似文献   

13.
We studied the possibility of enzymatic estimation of myocardial infarct size in patients late (between days 2 and 6) after the onset of acute myocardial infarction (AMI), in whom estimation of infarct size was difficult by analysis of time-activity curves of serum creatine kinase (CK) because of the lack of the enzymatic information during the initial 48 hours. Serial determinations of serum enzymes were performed in 32 patients within 6 hours after the onset of AMI and significantly close correlations were observed between cumulative total CK release and the cardiac fraction of lactate dehydrogenase isoenzyme (LDH1) activities from day 2 to day 6 after the onset of AMI (r = 0.863 to 0.870; p less than 0.001). We developed a nomogram to estimate cumulative total CK release by serum LDH1 activities obtained between days 2 and 6 after AMI and evaluated the reliability of the nomogram. Cumulative total CK release obtained from serial serum CK activities correlated closely with total CK release obtained from the nomogram in the second group of patients with AMI (r = 0.923 to 0.946; n = 24; p less than 0.001). Our total CK nomogram requiring few blood samples was useful in late estimation of infarct size in patients who were admitted to the hospital between days 2 and 6 after the onset of AMI.  相似文献   

14.
心肌肌钙蛋白I与急性心肌梗死患者近期预后的关系   总被引:1,自引:0,他引:1  
目的 探讨急性心肌梗死 (AMI)患者血清心肌肌钙蛋白I(cTnI)水平与近期预后的关系。方法 测定 5 1例AMI患者的血清cTnI,根据cTnI水平分为二组 ,观察住院期间心力衰竭、缺血性胸痛、心脏性死亡的发生率 ,测定左心室射血分数 (LVEF) ,分析cTnI水平与它们的关系。结果 在 5 1例AMI患者中 ,cTnI较高组 2 9例 ,较低组 2 2例 ,住院期间发生心力衰竭为 4 1 38%相对于 9 0 9% ,(P <0 0 1) ,缺血性胸痛为 4 4 83%相对于 18 18% ,(P <0 0 5 ) ,心脏性死亡为 3例相对于 0例 ,LVEF为 4 8%± 12 %相对于 5 8%± 12 % ,(P <0 0 5 ) ,存在显著差异。结论 血清cTnI是AMI患者住院期间预后的独立预测因子。  相似文献   

15.
Early elevation of the serum myoglobin level in acute myocardial infarction (AMI) has been noted for years. In this study, 39 patients admitted to the Coronary Care Unit with acute chest pain within 72 hours (mean 12 +/- 15 hours) or electrocardiographic changes suspected of acute myocardial infarction had a serum myoglobin latex agglutination test to evaluate its diagnostic accuracy in acute myocardial infarction. Of these 39 patients, 24 had documented acute myocardial infarction as their final diagnosis. By the time of admission, 18 of the 24 cases with infarction had positive myoglobin tests (sensitivity 75%). Of those 15 cases without myocardial infarction, 13 had negative myoglobin tests (specificity 87%). If only those 17 cases admitted within 5 hours of the onset of chest pain were analyzed, the serum myoglobin test became positive in 8 of 10 cases with documented AMI but the 2 cases with negative results turned positive 2 hours later (sensitivity 80% to 100%). Due to the fact that myoglobin tests were negative in all other 7 cases without infarction, the specificity was 7/7 (100%). In contrast, the creatine phosphokinase isoenzyme study was positive only in 3 of these 10 patients with documented AMI in the first blood sample taken during admission. In conclusion, the serum myoglobin latex agglutination test is a quick and reliable method that helps in the early diagnosis of acute myocardial infarction.  相似文献   

16.
Vascular endothelial growth factor (VEGF) is a growth factor for vascular endothelial cells in vitro. The present study was designed to determine whether serum VEGF levels increase in patients with acute myocardial infarction (AMI) compared with patients with stable exertional angina and control subjects, and to examine the serial changes of serum VEGF levels in patients with AMI. We examined serum VEGF levels by using antibody prepared from serum immunized with human VEGF(121). The serum VEGF level (pg/ml) was higher (p < 0. 0001) on admission in the patients with AMI (177 +/- 19) than in those with stable exertional angina (61 +/- 7) and control subjects (62 +/- 6). The serum VEGF level (pg/ml) of the patients with AMI was 177 +/- 19 on admission, 125 +/- 9 on day 3, 137 +/- 11 on day 5, 242 +/- 18 at 1 week, and 258 +/- 22 at 2 weeks after admission. The value was higher on admission than on day 3 after admission (p = 0.014), the values were higher at 1 week and 2 weeks than on admission, on day 3, and 5 (p < 0.01). Furthermore, there were correlations between peak VEGF levels at 1 week or 2 weeks after admission and peak creatine kinase levels. The increase of VEGF on admission in the patients with AMI may be due to the hypoxia of acute myocardial ischemia. The elevation at 1 week and 2 weeks from the onset may cause the development of collateral circulation in relation to the healing of the infarction site.  相似文献   

17.
Human albumin has the ability to bind cobalt at the N-terminus. The exposure of circulating albumin to ischemic tissue alters the ability of albumin to bind cobalt, probably through a mechanism involving free-radical production. The Albumin Cobalt Binding (ACBTM) test measures the alteration in albumin metal binding, and elevation of the ACB test is thought to be an early indicator of myocardial ischemia. In a previous multicenter study of chest pain patients presenting to the emergency department (ED), this test demonstrated high negative predictive value and sensitivity in the sample collected at presentation for predicting cardiac troponin I (cTnl)-negative or cTnl-positive results 6–24 h later. Since the completion of that report, the European Society of Cardiology (ESC) and the American College of Cardiology (ACC) have redefined the criteria for the diagnosis of acute myocardial infarction (AMI). The data from the multicenter ACB study were re-examined using the new diagnostic criteria for AMI to determine if combining the ACB test with troponin improved the sensitivity of either assay used alone for early diagnosis of AMI. Assay values were compared to either the final discharge diagnosis made at each site or to a diagnosis of AMI using the strict application of the ESC/ACC guidelines. Using the criterion of physician's discharge diagnosis and using blood collected at ED presentation, the cTnl test alone had a sensitivity of 23.9%, and the ACB test alone had a sensitivity of 39.1%, but the sensitivity significantly increased to 55.9% (p<0.001 over cTnl alone) when both tests were used in combination. The sensitivity of the combination of ACB and cTnl tests at the 1- to 6-h time-point was 86.7% and at the >6- to 12-h time-point was 93.5%, but they were not significantly improved over the cTnl test alone. In conclusion, using the new ESC/ACC criteria, the combination also resulted in a statistically significant higher diagnostic sensitivity on blood collected at presentation. These data indicate a possible role of the ACB test in the early triage of patients with chest pain.  相似文献   

18.
To test the hypothesis that scans with technetium-99m pyrophosphate (Tc-99m-PPi) are positive when performed early after successful thrombolytic therapy for acute myocardial infarction (AMI), 16 consecutive patients with AMI who received thrombolytic therapy within 5 hours after the onset of chest pain were studied. Patients were included if chest pain lasted for greater than 30 minutes, was unresponsive to sublingual nitroglycerin and was associated with at least 0.2 mV ST-segment elevation in at least 2 contiguous electrocardiographic leads. All patients received 1.5 million IU of streptokinase intravenously, a mean of 195 +/- 99 minutes after onset of chest pain. Tc-99m-PPi scans and coronary cineangiograms were recorded 491 +/- 156 minutes and 518 +/- 202 minutes, respectively, after the onset of symptoms. Effective reperfusion was present in 10 patients, 6 of whom had positive Tc-99m-PPi scans (sensitivity of 60% to detect reperfusion). Of the 6 patients without effective reperfusion, 3 had positive Tc-99m-PPi scans (specificity of 50%, p greater than 0.05). Analysis of the data using various definitions of effective reperfusion or artery patency yielded similar results. Thus, our findings indicate that early AMI scanning with Tc-99m-PPi does not accurately detect the presence or absence of reperfusion in patients with AMI after treatment with intravenous streptokinase. At this time, coronary cineangiography is the only reliable method to detect reperfusion promptly after thrombolytic therapy.  相似文献   

19.
OBJECTIVE: The purpose of this study was to investigate the clinical significance of vascular endothelial growth factor (VEGF) in acute myocardial infarction (AMI). We also examined the involvement of peripheral blood mononuclear cells (PBMCs), which are a possible source of VEGF in AMI. BACKGROUND: VEGF is a potent endothelial cell-specific mitogen and could affect the outcome of AMI. METHODS: Thirty patients with AMI were used for this study. Serum and PBMCs were isolated from peripheral blood on days 1, 7, 14 and 21 after the onset of AMI. PBMCs were cultured at a density of 5 x 10(6) cells/ml for 24 h. VEGF levels in serum and the culture media were measured by enzyme-linked immunosorbent assay using a specific anti-human VEGF antibody. RESULTS: Serum VEGF levels elevated gradually after the onset of AMI and reached a peak on day 14. VEGF levels in the culture medium of PBMCs after incubation for 24 h (PBMC-VEGF) were maximally elevated 7 days after the onset. Maximum serum VEGF levels showed significant positive correlations with maximum creatine phosphokinase (CPK) levels (r = +0.70, p < 0.001), but maximum PBMC-VEGF levels did not correlate with maximum CPK levels. Patients showing improvement in left ventricular systolic function during the course of AMI showed significantly higher PBMC-VEGF levels than patients without improvement. CONCLUSIONS: The extent of myocardial damage contributes to the elevation of serum VEGF levels in AMI. VEGF produced by PBMCs may play an important role in the improvement of left ventricular function by promoting angiogenesis and reendothelialization after AMI.  相似文献   

20.
应用McAb-Dot-ELISA平行检测了人宿主的血清和尿样(浓缩20倍)中日本血吸虫肠相关趋阴极循环抗原(CCA)。81例急性血吸虫病患者的血清和尿样的阳性率分别为96.30%和66.67%。而血清和尿样组合检测的阳性检出率提高至100%。109例慢性血吸虫病患者的血清和尿样的阳性检出率分别为77.06%和10.09%,组合检测的阳性检出率没有提高。100份健康人的血清和尿样的假阳性率均为0%。53例华枝睾吸虫病患者的血清和尿样的交叉反应率分别为9.43%和0%。48例钩虫病患者的血清和尿样的交叉反应率均为0%。  相似文献   

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