hs-CRP、cTnI、Mb、CK-MB 测定对急性冠状动脉综合征的诊断价值

目的 探讨高敏C反应蛋白(hs-CRP)、肌钙蛋白I(cTnI)、肌红蛋白(Mb)、肌酸激酶同工酶(CK-MB)测定在急性冠状动脉综合征(ACS)中的诊断价值.方法 对30例ST段抬高(STEMI)ACS和23例非ST段抬高(NSTEMI)ACS患者于症状出现后的0～2 h、4～6 h分别进行hs-CRP、cTnI、Mb和CK-MB检测,并进行比较分析.结果 (1)ST段抬高组和非ST段抬高组0～2 h:hs-CRP和Mb检测阳性率高于cTnI和CK-MB,春差异有统计学意义(P＜0.01);且两组间cTnI、Mb、CK-MB阳性率差异有统计学意义(P＜0.01).(2)4～6 h:ST段抬高组hs-CRP、cTnI、Mb、CK-MB检测阳性率差异无统计学意义(P＞0.05);而非ST段抬高组hs-CRP、cTnI、Mb检测阳性率高于CK-MB,且两组间所有结果比较差异均有统计学意义(P＜0.05).结论 ACS患者早期检测hs-CRP、Mb,敏感性优于cTnI、CK-MB;hs-CRP、cTnI、Mb能检测出微小心肌损伤;非ST段抬高的ACS患者有50%左右存在微小心肌梗死;hs-CRP、cTnI、Mb、CK-MB测定对诊断SIEMI具有很高的敏感性.

Diagnostic value of hs-CRP,cTnI,Mb and CK-MB in acute coronary artery syndrome

Objective To investigate the diagnostic value of determining high sensitive C reactive protein(hs-CRP),troponin I(cTnI),myohemoglobin(Mb) and creatinkinase (CK-MB) in acute coronary artery syndrome(ACS)patients.Methods hs-CRP ,cTnI,Mb and CK-MB were detected respectively in thirty examples of ACS with STEMI and twenty-three examples of ACS with NSTEMI at 0-2 h and 4-6 h after symptom appearance.The results were analyzed comparatively.Results (1)Positive rate of hs-CRP and Mb increased manifestly than that of cTnI and CK-MB(P<0.01)in ST raise group at 0-2 h.The positive rate of cTnI,Mb,CK-MB between two groups had significant difference(P<0.01).(2)The positive rates of hs-CRP,cTnI,Mb and CK-MB had no significant difference in ST raise group at 4-6 h(P>0.05).The positive rates of hs-CRP,cTnI and Mb increased manifestly than that of CK-MB in NSTEMI group,and there was significant difference between the two groups(P<0.05).Conclusion Early detection of hs-CRP and Mb is more sensitive than early detection of cTnI and CK-MB in ACS.Minor myocardial damage of ACS can be detected by hs-CRP,cTnI and Mb.There is minor myocardial damage in 50% of ACS patients with NSTMEI.The detection of hs-CRP ,cTnI,Mb and CK-MB has high sensitivity for diagnosing STEMI.