血清hs-CRP、CK-MB、cTnI在急性心肌梗塞早期诊断中的临床价值

目的探讨血清hs-CRP、CK-MB与cTnI在急性心肌梗塞(AMI)早期中的临床价值。方法对36例AMI胸痛发作在3￣4h患者,50例AMI胸痛发作4￣12h患者,采用定时免疫散射比浊法检测其血清hs-CRP,免疫抑制法测定血清CK-MB,化学发光法检测血清cTnI,并与40例健康对照作比较,探讨三者在AMI早期中的变化情况。结果AMI胸痛发作3￣4h组、4￣12h组hs-CRP含量分别为(7.42±3.27)mg/L、(25.26±18.15)mg/L,均明显高于对照组(0.84±0.73)mg/L(P<0.01);CK-MB含量AMI胸痛发作3￣4h组(25.4±14.6)U/L与4￣12h组(64.6±53.2)U/L均较对照组(5.6±3.4)U/L有显著性差异(P<0.05);而AMI胸痛发作3￣4h组cTnI含量(0.08±0.06)μg/L与对照组(0.06±0.04)μg/L无显著性差异(P>0.05),4￣12h组的cTnI含量(28.9±37.6)μg/L与其它两组比较均有显著性差异(P<0.05)。AMI患者胸痛发作4h内,以hs-CRP(91.7%)最敏感,CK-MB(55.6%)次之,阳性检出率均明显高于cTnI(25%);胸痛发作4￣12h,hs-CRP(100%)、CK-MB(92%)、cTnI(84%)均具有较高的阳性检出率。结论联合检测hs-CRP、CK-MB、cTnI对于AMI早期诊断具有很高的灵敏度与特异性,可将诊断与治疗提前到4h以内,并能作为AMI的预后监测及疗效观察的指标。

Clinical value of measuring serum level of high sensitivity C-reactive protein,creatine kinase MB and cardiac troponin I for acute myocardial infarction in early stage

Objective To investigate the value of measuring serum level of hs-CRP,CK-MB and cTnI in patients with acute myocardial infarction in early stage. Methods The serum levels of hs-CRP,CK-MB and cTnI were measured in 36 patients with AMI in 3~4 hours after the onset of symptoms and 50 cases in 4~12 hours after the onset of symptoms and 40 healthy, respectively.Results The level of hs-CRP was significantly higher both in patients with an onset in 3~4 hours of AMI and in patients with an onset in 4~12 hours of AMI than that of the healthy(P<0.01);The level of CK-MB was significantly higher both in patients with an onset in 3~4 hours of AMI and in patients with an onset in 4~12 hours of AMI than that of the healthy(P<0.05); The level of cTnI was significantly higher in patients with an onset in 4~12 hours of AMI than that of the healthy(P<0.05), but there was no difference between the level of cTnI in patients with an onset in 3~4 hours of AMI and that of the healthy(P>0.05).The positive rate of hs-CRP (91.7%) was higher than that of the two others(CK-MB 55.6%,cTnI 25%) in patients within 4 hours after the onset of symptoms. The positive rates of CK-MB (92%)and cTnI (84%)were observed very high after the onset 4 hours later.Conclusion The measurement of serum hs-CRP,CK-MB and cTnI in patients with AMI within 4 hours was very important to save the lives of patient with AMI in early stage.