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目的探讨肌红蛋白(Mb)、肌钙蛋白T(cTnT)、肌酸激酶同工酶(CK-MB)对急性心肌梗死的诊断应用价值。方法肌红蛋白用免疫比浊法测定;cTnT用BECKMAN Access2化学发光仪测定;CK-MB用贝克曼LX-20全自动生化分析仪测定;然后进行统计学分析。结果 Mb诊断灵敏度在8h达到最高为85%,cTnT灵敏度在24h达99.5%,显著高于Mb的灵敏度,但与CK-MB无明显差异。特异性最高的是CK-MB,在4、8、12、24h的四个时间段平均特异性为98.5%,但与Mb相比差异无统计学意义(P>0.05),在各个四个时点Mb阳性预测值明显高于cTnT的阳性预测值(P<0.01),但与CK-MB的阳性预测值无明显的差别(P>0.05),阴性预测值在4h Mb高于cTnT和CK-MB。结论检测Mb、cTnT、CK-MB的准确性、灵敏度可靠,对急性心肌梗死的早期诊断有重要价值。
Objective To investigate the diagnostic value of myoglobin (Mb), troponin T (cTnT) and creatine kinase isoenzyme (CK-MB) in patients with acute myocardial infarction. Methods Myoglobin was measured by immunoturbidimetry; cTnT was measured by BECKMAN Access2 chemiluminescence instrument; CK-MB was measured by Beckman LX-20 automatic biochemical analyzer; then statistical analysis was performed. Results The diagnostic sensitivity of Mb reached 85% at 8h, the sensitivity of cTnT reached 99.5% at 24h, which was significantly higher than that of Mb, but no significant difference with CK-MB. The highest specificity was CK-MB, with an average specificity of 98.5% at four time points of 4, 8, 12 and 24 hours, but no significant difference compared with that of Mb (P> 0.05) The positive predictive value of point Mb was significantly higher than that of cTnT (P <0.01), but not significantly different from the positive predictive value of CK-MB (P> 0.05). The negative predictive value of Mb at 4h was higher than that of cTnT and CK- MB. Conclusion The accuracy of detecting Mb, cTnT and CK-MB is reliable and reliable, which is of great value in the early diagnosis of acute myocardial infarction.