三项心肌标志物在各类型冠心病诊断中的应用及评价

目的了解3项心肌标志物对急性心肌梗死(AMI)、不稳定心绞痛(UAP)和稳定性心绞痛(SAP)的诊断价值,以资评估。方法心肌肌钙蛋白I(CTnI)和肌红蛋白(Myo)采用荧光抗原抗体法,心肌酶谱(MEP)采用速率法。对67例各类型冠心病(CHD)的血清中CTnI、Myo和"MEP"含量检测,并对结果加以比较和分析。结果 AMI 28例的3项指标异常检出率分别为78.57%、75.00%和85.71%;UAP 20例,异常检出率分别为45.00%、40.00%和20.00%;SAP 19例,3项指标的异常检出率分别为零、零和5.26%。若3项指标在AMI、UAP和SAP患者中异常检出结果各项各组之间互为交叉比较,结果除MEP诊断UAP与SAP结果差异无统计学意义外,其他各项各组结果比较,差异均有统计学意义(P0.05或P0.01)。结论 3项心肌标志物各具有特点,对冠心病各类型均有早期诊断和鉴别诊断的意义。3项指标一起用于临床,对急性冠脉综合征(ACS)早期判断、预后、预测、危险分层、风险评估等具有诊断价值。

Application and evaluation of three cardiac markers in diagnosis of various types of coronary heart disease

Objective] To understand the clinical value of 3 cardiac markers （CTnI, Myo,＂ MEP＂} in diagnosis of AMI, UAP, SAP as a way of assessment. Methods ] The fluorescent antigen antibody method was adopted for CTnI and Myo detection, and performance rate method for MEP. The CTnI, Myo, MEP contents of 67 CHD cases were detected, and the results were compared and analyzed. Results] The abnormal detection rate of CTnI, Myo,＂MEP＂ of 28 AMI cases were78.57% , 75.00% and 85. 71% ; 45.00%, 40.00% and 20.00% for 20 UAP cases, and O, 0 and 5.26% for 19 SAP cases. Comparing the CTnI, Myo, MEP between the abnormal resuhs of AMI,UAP and SAP patients in each group and each item, except for the MEP between UAP and SAP patients, the other differences were all significant （ P 〈 0.05 orP 〈 O. 01 ）. Conclusion ] Three cardiac markers have spe- cial characteristics, and all have significance of early diagnosis and differential diagnosis. The combination of 3 markers has diag- nostic value in early judgments, prognosis, prediction, risk stratification and risk assessment of ACS.