急性心肌梗死诊断中多个时段心肌肌钙蛋白Ⅰ临界值的比较

目的通过动态监测急性心肌梗死(AMI)患者胸痛后3个时段(4、6和10 h)心肌肌钙蛋白Ⅰ(cTnI)含量,设置3个不同临界值,为诊断AMI提供准确的标准。方法用化学发光法测定AMI组及非AMI组血液中cTnI含量,用统计软件绘制受试者工作特征曲线(ROC曲线)。结果根据ROC曲线,4 h cTnI用于诊断AMI的临界值为0.383μg/L,敏感度为88%,特异性为75%;6 h cTnI临界值为0.815μg/L,敏感度为95%,特异性为95%;10 h cTnI临界值为2.065μg/L,敏感度为98%,特异性为100%。结论针对不同时段的cTnI测定值应分别选择各自时段的临界值,可提高其用于临床诊断AMI的实用性及敏感性。

Critical value comparison of cardiac troponin I at different times in diagnosis of acute myocardial infarction

Objective To calculate the critical values of cardiac troponin Ⅰ（cTnI） in different time intervals（4h,6 h and 10 h after the onset of chest pain.） for the patients with actue myocardial infarction（AMI）,to provide the accurate criteria for diagnosing AMI.Methods To determine the cTnI level in AMI patients and in control group by chemiluminescence immunoassay analyzer.The data were analyzed with statistical software for drawing ROC curve.Results According to the ROC curve,the critical value of cTnI was 0.383 μg/L at 4 h after the diagnosis of AMI with the sensitivity of 88% and the specificity of 75%;0.815 μg/L at 6 h with the sensitivity of 95% and the specificity of 95%;2.065 μg/L at 10 h with the sensitivity 98% and the specificity of 98%.Conclusion Selecting related critical value of cTnI in the different time intervals can increase the practicability and sensitivity in the clinical diagnosis of AMI.