急性冠状动脉综合征病人cTnI和Mb动态变化及意义

目的探讨急性冠状动脉综合征（ACS）病人血清心肌肌钙蛋白I（cTnI）和肌红蛋白（Mb）浓度的动态变化及其临床意义。方法采用ELISA法检测了44例急性心肌梗死（AMI）和38例不稳定型心绞痛（UA）病人不同时间血清cTnI和Mb浓度的变化，并与对照组40例健康查体者进行比较。结果AMI病人胸痛发作后不同时间的血清cTnI浓度差异均有显著性（F=106．525，q=3．285～24．548，P〈0．05、0．01），胸痛发作后3～6h和24h血清Mb浓度与3d和7d比较均有显著性差异（F=19．702，q=7．641～11．019，P〈0．01）。AMI病人胸痛发作后不同时间血清cTnI浓度与对照组和UA病人相比较，差异有显著意义（F=106．525、19．702，q=3．361—27．793，P〈0．05、0．01），胸痛发作后3～6h、24h血清Mb浓度与对照组和UA病人比较差异有显著意义（F=19．702，q=7．770～9．747，P％0．01）。结论血清cTnI和Mb浓度的动态变化对AMI具有明显的早期诊断价值。

THE DYNAMIC CHANGES OF SERUM cTnI AND Mb IN PATIENTS WITH ACUTE CORONARY SYNDROME

Objective To explore the dynamic changes and their clinical significance of serum cardiac troponin I （cTnI） and myoglobin （Mb） in patients with acute coronary syndrome （ACS）. Methods The serum concentrations of cTnI and Mb at different times in 44 patients with acute myocardial infarction （AMI） and 38 patients with unstable angina （UA） were determined by enzyme-linked immunosorbent assay, the findings were compared with 40 healthy controls. Results The serum cTnI of AMI patients at different times after the onset of chest pain was significantly different （F= 106. 525, q = 3. 287- 24. 560, P〈0. 05, 0.01）. After chest pain, the serum Mb at 3- 6 hand24 h were higher than that at 3 and7 days （F=19.702,q=7.641-11.019, P〈0.01）. The serum cTnI of AMI patients at different times after the onset of chest pain was significantly higher than that of the controls and UApatients （F=106.525,q=3.361-27.793,P〈0.05,0.01）. The serumMb of AMI patients at 3-6 h and 24 h after chest pain were higher than that of the controls and UA patients （F= 19. 702, q = 7. 770- 9. 747, P〈0. 01）. Conclusion The dynamic changes of cTnI and Mb concentrations have significant value in the early diagnosis of AMI.