血清肌钙蛋白检测对急性心肌梗死诊断的临床价值探讨

目的:比较血清肌钙蛋白(cTnT)与肌酸肌酶(CK)及心肌型肌酸激酶同功酶(CK-MB)在诊断急性心肌梗塞(AMI)中的价值。方法:采用酶联免疫吸附方法,对36例急性心肌梗塞患者、45例心绞痛(AP)疑有微小心肌损伤(MMD)患者以及38例健康(HP)人进行心脏肌钙蛋白T(cTnT)测定,同时作CK和CK-MB两项酶学指标相比较。结果:AMI组,cTnT、CK及CK-MB三者之间的异常率无明显差别(异常率97%~100%);而AP组,cTnT的异常率为35.5%,明显高于CK异常率的8.9%和CK-MB异常率的13.3%。与健康组相比,AP组的cTnT测定的水平明显高于对照组水平(P<0.001)。结论:对于不同程度的急性缺血性心肌损伤的诊断,cTnT较CK及CK-MB,具有更高的灵敏度及特异性。

Value of cTnT in the Diagnosis of Acute Myocardial Infarction

Objective To compare the value cardiac troponin(cTnT),creatine kinase(CK) and MB isoenzyme of creatine kinase(CK-MB)in detection of acute myocardial infarction(AMI).Methods Cardiac troponin T of 36 patients with AMI,45 patients with uncertain minor myocardial damage(MMD) angina and 38 healthy persons were detected by ELISA,compared with CK and and CK-MB.Results There was no significant differences in cTnT,CK and CK-MB of AMI patients(abnormal rate between 97% and 100%),but for angina patients,abnormal rate of cTnT(35.5%) was much higher than that of CK(8.9%) and CK-MB(13.3%);and cTnT of angina patients was much higher than that of healthy persons(P<0.01).Conclusion cTnT is of much sensitivity and specificity than CK and CK-MB for the detection of AMI.