生化标志物联合检测在缺血性心肌损害中的诊断价值

目的探讨生化标志物：缺血修饰清蛋白（IMA）、肌红蛋白（Mb）、肌酸激酶同工酶（CK—MB）、肌钙蛋白I（CTnI）联合检测对缺血性心肌损害的早期诊断价值。方法选择因急性胸痛来本院就诊的患者95例，在胸痛≤1h、3h、6h、12h、24h连续监测IMA、Mb、CK～MB、CTnI4项指标，观察其在疾病过程中的变化规律。结果有典型心肌梗死心电图变化组入院：在胸痛≤1hIMA、Mb、CK—MB、CTnI敏感性分别为81．0％、38．1％、28．5％、14．2％，IMA敏感性与其他3项相比差异均有统计学意义（P〈0．05）。在胸痛≤3h时IMA、Mb、CK—MB和CTnI4项指标联合检测敏感性为95．3％，均高于单项检测，差异有统计学意义（P〈0．05）。结论在缺血性心肌损害的早期，IMA是一个比较灵敏的指标，IMA、Mb、CK—MB、CTnI联合检测诊断缺血性心脏病，明显提高了检测的灵敏度，具有较高的临床实用价值。

Clinical diagnotic value of combined detection of biochemical markers in myocardial ischemic injury

Objective To investigate the early diagnostic value of combined detection value of biochemical markers including ischemia modified album （IMA）, myohemoglobin （Mb）, creatine kinase isozyme （CK-MB） and cardiac tropnin I （cTnI） in myocardial ischemic injury. Methods Ninety-five patients with acute chest pain were enrolled in the investigation. Four biochemical markers （IMA, Mb, CK-MB and cTnI） were monitored continually at different time-points （1, 3, 6, 12 and 24 h after chest pain onset）. The law of the parameters dynastic changes was investigated in the course. Results In the group of typical varying electrocardiograph, the sensitivity was 81.0% for IMA, 38.1% for Mb, 28.5% for CK-MB and 14.2% for cTnI at 1 h time-point. Its sensitivity of IMA was remarkable different from the other three groups （P〈0.05）. The sensitivity of combined detection of IMA, Mb, CK-MB and cTnI was 95.3%, much higher than any single detection at 3 h time-point （P〈0.05）. Conclusion IMA is an early and sensitive marker for myocardial ischemic injury. Combined detection of IMA, Mb, CK-MB and cTnI significantly enhances sensitivity and has a high practical clinical value.