四项指标联合检测对急性心肌梗死早期诊断价值的探讨

目的探讨心肌肌钙蛋白I（cTnI）、肌红蛋白（Myo）、肌酸激酶同工酶（CK-MB）以及超敏C-反应蛋白（hs-CRP）四项指标的联合检测在急性心肌梗死诊断中的临床应用价值。方法对40例急性心肌梗死患者（A组）,35例不稳定型心绞痛患者（B组）和50例健康体检者（C组）在首诊（胸痛发作4 h之内）时进行cTnI、Mb、CK-MB和hs-CRP检测,比较它们各自及联合检测时对急性心肌梗死诊断的敏感性。结果急性心肌梗死患者血中cTnI、Myo、CK-MB和hs-CRP水平显著高于不稳定型心绞痛患者和对照组,差异有显著统计学意义（P〈0.01）,且急性心肌梗死患者血中cTn I、Myo、CK-MB和hs-CRP水平高于不稳定型心绞痛患者（P〈0.05）。cTnI、Myo、CK-MB、hs-CRP及四项指标联合测定急性心肌梗死的阳性率分别为75%、82.5%、65%、87.5%和97.5%。结论 cTnI、Myo、CK-MB和hs-CRP对急性心肌梗死诊断有重要临床意义,联合检测可以提高急性心肌梗死诊断的灵敏度,具有较高临床价值。

Clinical value of joint detection of four tests in early diagnosis of acute myocardial infarction

Objective To explore clinical application value of combined detection of cTnⅠ,Myo,CK-MB and serum hs-CRP for the diagnosis of acute myocardial infarction.Methods The serum levels of cTnⅠ,Myo,CK-MB and hs-CRP were determined at presentation in 40 patients with acute myocardial infarction,35 patients with unstable angina pectoris and 50 healthy subjects at 0-4 hours after acute chest pain outbreak.The respective sensitivity and their joint sensitivity were reanalyzed.Results The levels of cTnⅠ,Myo,CK-MB and hs-CRP were significantly higher in AMI group than other tow groups（P0.01）.The levels of cTnⅠ,Myo,CK-MB and hs-CRP were higher in AMI group than unstable angina pectoris groups（P0.05）.The positive rate of acute myocardial ischemia diagnosis： cTnI was 75 %,Myo was 65%,CK-MB was 82.5%,hs-CRP was 87.5 % and their incombination was 97.5%.Conclusion The levels of cTnⅠ,Myo,CK-MB and hs-CRP have very impartment value in diagnosing acute myocardial infarction.Joint detection can improve the sensitivity of acute myocardial ischemia diagnosis.