心肌肌钙蛋白T测定在急性心肌梗塞中的临床意义

目的：探讨急性心肌梗塞患者血清心肌肌钙蛋白T（cTnT）含量变化及与心功能、左室射血分数（LVEF）、梗塞范围、室性心律失常的关系．方法：分别测定了33例急性心肌梗塞（AMI）患者，15例骨骼肌损伤者和20例健康者的cTnT、肌酸磷酸激酶（CK）及其同工酶（CK—MB）．结果：所有健康者、骨骼肌损伤者的cTnT浓度均正常．cTnT在AMI中出现于发病后5小时左右，与CK、CK—MB相似，持续时间2～3周，其峰值与LVEF成负相关，与心功能、梗塞范围成等级相关，与室住心律失常不相关．结论：cTnT诊断AMI的敏感性与CK、CK—MB相似，特异性更好，持续时间更长，溶栓成功者CTnT成双峰，其首峰提前至16小时．

Clinical Value of Cardiac Troponin T in the Diagnosis of Acute Myocardial Infarction

To approach the changes of concentration of cardiac troponin T (cTnT)and its relationship with cardiac function, left ventricle ejection fraction (LVEF),infarction size and ventricular arrhythimias in the patients with acute myocardial infarctiou (AMI). Mathod The serum levels of cTnT,CK and CK-MB were resistively determined in 33 patients with AMI, 15 patients with skeleton muscle damages (SMD) and 20 healthy subjects. Results The results showed that the serum levels of cTnT were normal in the healthy controls and Patients with SMD. The increasing of cTnT in confirmed AMI started about five hours after the onset of the symptoms, similar to CK and CK - MB, and was sustained for two to three weeks. The peak of cTnT were negatively correlated to LVEF,gradely correlated to cardiac function and infarction size,but had no correlation with ventricular arrhythmias. Conclusion it suggests that the sensitivity of cTnT in the diagnosis of AMI was similar to that of CK and CK-MB, but its specificity was higher and its duration was longer.