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三种心肌损伤标志物对急性心肌梗死的诊断效率评价
引用本文:陈永红,张玉萍,陶鹏辉,余德玲. 三种心肌损伤标志物对急性心肌梗死的诊断效率评价[J]. 国际检验医学杂志, 2007, 28(4): 334-336
作者姓名:陈永红  张玉萍  陶鹏辉  余德玲
作者单位:河南省信阳市中心医院检验科,464000;河南省信阳职业技术学院附属医院,464000
摘    要:目的 探讨心肌钙蛋白Ⅰ(cTnⅠ)、肌红蛋白(Myo)、肌酸激酶同工酶(CK-MB)单项和联合检测诊断急性心肌梗死(AMI)的敏感性和特异性。方法 分别采取患者发病后2、4、8小时静脉血,采用美国BECKMAN公司180SE ACCESS微粒子全自动化学发光分析仪及配套试剂,24h全天候开机,在1h内完成3项指标的检测。结果 在发病后2小时,只有Myo的敏感性达到45.36%。发病后4小时,Myo、cTnⅠ和CK-MB敏感性分别为89.81%、48.46%和53.92%。cTnⅠ+Myo和cTnⅠ+CK-MB的特异性分别为83.89%和85.27%。发病后8小时,cTnⅠ、Myo和CK-MB敏感性均达到100.00%,特异性从高到低依次为cTnⅠ+Myo+CK-MB(100.00%)〉cTnⅠ+CK-MB〉cTnⅠ+Myo〉Myo+CK-MB〉cTnⅠ〉CK-MB〉Myo(76.35%)。结论 cTnⅠ、Myo、CK-MB单项和多项联合检测能很好地诊断AMI,但不同时间段各项指标的敏感性和特异性差别较大,临床应连续采血检测才能提高诊断率和制定最佳治疗方案。

关 键 词:心肌梗死  肌钙蛋白I  肌红蛋白  肌酸激酶  同工酶类

Efficiency of three kinds of myocardial injury markers in AMI diagnosis
CHEN Yong-hong,ZHANG Yu-ping,TAO Peng-hui,et al.. Efficiency of three kinds of myocardial injury markers in AMI diagnosis[J]. International Journal of Laboratory Medicine, 2007, 28(4): 334-336
Authors:CHEN Yong-hong  ZHANG Yu-ping  TAO Peng-hui  et al.
Affiliation:CHEN Yong-hong,ZHANG Yu-ping,TAO Peng-hui,et al.Department of Clinical Laboratory,Xinyang Central Hospital,Xinyang 464000,China
Abstract:Objective To investigate sensitivity and specificity of detection of cTnI,Myo,and CK-MB in diagnosing acute myocardial infarction separately and in combination.Methods The venous blood samples from AMI patients were collected at different time-points(2,4,8 h) after heart attack.Three indexes(cTnI,Myo,and CK-MB) detection was completed within one hour by means of a microsome full automatic chemiluminescence analyzer(180SE Access of American Beckman Company) and its relevant reagents.The analyzer kept on working for a whole day.Results At 2 h after attack,only the sensitivity of Myo reached 45.36%.At 4 h after attack the sensitivity of Myo,cTnI and CK-MB reached 89.81%,48.46% and 53.92% respectively.The specificity of cTnI + Myo and cTnI + CK-MB was 83.89% and 85.27% respectively.At 8 h after attack,the sensitivity of cTnI,Myo and CK-MB all reached 100.00%,and the specificity in turn from high to low was cTnI + Myo + CK-MB(100.00%)>cTnI + CK-MB>cTnI + Myo>Myo + CK-MB>cTnI>CK-MB>Myo(76.35%).Conclusion AMI can be diagnosed effectively by both separated and combined examination with cTnI,Myo,and CK-MB,but there is a significant difference of sensitivity and specificity in each index during different period of one hour,so only continuous blood-taking and examination can raise clinical diagnostic rate and establish a best therapeutic strategy.
Keywords:Myocardial infarction  Troponin I  Myoglobin  Creatine kinase  Isoenzymes
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