联合检测心肌肌钙蛋白Ⅰ和超敏C-反应蛋白在急性心肌梗死诊断中的意义

目的 探讨心肌肌钙蛋白I(cTnI)和超敏C-反应蛋白(hs-CRP)联合检测对急性心肌梗死(AMI)的诊断价值.方法 检测192例AMI患者不同时段血清cTnI和hs-CRP水平,同时检测200例健康体检者血清cTnI和hs-CRP作对照,并对结果进行统计学分析.结果 AMI组与对照组cTnI和hs-CRP浓度比较有差异有统计学意义(P<0.01),cTnI在AMI胸痛发作12～24 h达到峰值,峰值为(9.68±2.64)μg/L;hs-CRP在AMI胸痛发作8～12 h达到峰值,峰值为(14.5±5.9)mg/L.cTnI和hs-CRP对AMI诊断灵敏度在AMI发作0～8 h和3～7 d差异均有统计学意义,8 h至3 d诊断灵敏度差异无统计学意义,cTnI和hs-CRP对AMI诊断特异度分别为98.5%和84.0%.结论 cTnI诊断AMI具有很高的特异性和较宽的诊断时间,hs-CRP对AMI的早期诊断具有很高的敏感性,二者联合检测可以更好的发挥cTnI和hs-CRP诊断AMI的优点,争取AMI早诊断、早治疗和减少对AMI漏诊、误诊,为AMI诊断提供必要的信息.

Diagnostic value of combined detection of cTnI and hs-CRP in patients with acute myocardial infarction

Objective To explore the clinical significance of combined detection of cardiac troponin I（cTnI） and high sensitivity C-reactive protein（hs-CRP） in diagnosis of acute myocardial infarction（AMI）.Methods The serum concentration of cTnI and hs-CRP were detected in 192 patients with AMI and 200 normal people.Results The serum concentration of cTnI and hs-CRP in AMI group were significantly higher than that in the control group（P0.01）.cTnI reached the peak[（9.68 ±2.64）μg/L] at 12~24 h and hs-CRP reached the peak [（14.5±5.90）mg/L] at 8~12 h after chest pain in AMI.The sensitivity of cTnI and hs-CRP in diagnosis of AMI had significant difference in 0～8 h and 3～7 d after chest pain while no significant difference in 8 h～3 d.The specificity of cTnI and hs-CRP was 98.5% and 84.0%respectively.Conclusion cTnI has high specificity in diagnosis of AMI and wide diagnosis time while hs-CRP has high sensitivity.The early diagnosis and treatment may be improved and some information of the infarction moment may be provided if they are measured together.