肌钙蛋白I在急性心肌梗死和不稳定性心绞痛诊断中的意义

目的 :研究心肌肌钙蛋白I(cTnI)在诊断急性心肌梗死 (AMI)中的意义和在预测不稳定性心绞痛 (UA)发生心脏事件中的价值。方法 :对AMI患者血清中cTnI和肌酸激酶同工酶 (CK -MB)进行了动态观察 ,并对UA患者进行随访 ,观察其血清cTnI浓度与其 1～ 2月内发生心脏事件的关系 ,评价其对不稳定性心绞痛的预后价值。结果 :在AMI胸痛后 4小时内 ,6 0例病人cTnI阳性为 5 2例 ,检出率为 86 6 7% ,与CK -MB有明显的差异 (P <0 0 1) ;4 0例UA病人cTnI阳性为 18例 ,检出率为 4 5 % ,与CK -MB有明显的差异 (P <0 0 5 ) ;在对AMI的动态观察中 ,cTnI在发病后 4小时即有很高的检出率 ( 86 6 7% ) ,12～ 2 4小时达到高峰 ,其阳性率为 10 0 % ,在 5天和 7天时仍有很高的检出率 (分别为 6 8 33%和4 0 % ) ;在对UA的随诊观察中 ,cTnI高于正常的UA患者 ,其预后要比cTnI正常的差 ,其心脏事件发生率具有明显的差异性 (P <0 0 5 )。结论 :cTnI能敏感地反映心肌损伤 ,并且特异性较好。在对早期急性和中晚期亚急性AMI的检测方面具有很高的价值 ,在对UA的预后评价方面也有重要的意义

The Significance of Myocardial Troponin I in Diagnosing Acute Myocardial Infarction and Unstable Angina

Objectives:To study the significance of myocardial troponin I in diagnosing acute myocardial infarction and unstable angina as well as its value in evaluating the prognosis of unstable angina.Methods:Observing the dynamic changes of cTnI and CK MB in serum of patients with AMI, and following up the patients with UA for 1 2 months to observe correlation between cTnI and cardiac events occurring and evaluate its value for predicting the prognosis of unstable angina. Results:During the 4 hours of patients with AMI being chestache, the cTnI are positive in 52 of 60 patients with AMI and the ratio is 86.67%; the cTnI in 18 of 40 patients with UA are positive and the ratio is 45%. Comparing with CK MB, the difference in diagnosing AMI is great. During the dynamic observation of the patients with AMI, the cTnI was easily measured at early stage as 4 hours after chestache, and even at late stage as 5 or 7 days after chestache. In the following investigation of patients with UA, the prognosis for patients whose cTnI were positive were much worse than those whose cTnI were normal. Conclusions:The cTnI has the sensitivity and specificity for diagnosing acute myocardial infarction and unstable angina, and has the great significance in evaluating the prognosis of patients with unstable angina.