论文部分内容阅读
目的评价心肌酶谱联合肌钙蛋白（cTnT）在急性非ST段抬高心梗（NSTEMI）患者早期诊断中的应用价值。方法将128例高度怀疑非ST段抬高型冠脉综合征患者根据诊断分为非ST段抬高性心梗（NSTEMI组，76例）、不稳定心绞痛（UA组，52例），同时选择50例健康者作为对照。测定所有对象入院时血清cTnT和心肌酶谱包括谷草转氨酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)的水平。结果 NSTEMI组、UA组血清cTnT与心肌酶谱水平较对照组明显升高，NSTEMI组患者血清cTnT与心肌酶谱均高于UA组（<0.05）；NSTEMI患者cTnT与AST、LDH、CK及CK-MB水平均呈正相关（<0.05）；入院时间<5h、5~10h，心肌酶谱+cTnT对NSTEMI的诊断阳性率均显著高于单用心肌酶谱（<0.05）。结论心肌酶谱与cTnT联合检测可减少诊疗过程中误诊和漏诊，提高NSTEMI的早期诊断率。“,”Objective To evaluate the clinical application value of serum cardiac troponin T (cTnT), myocardial enzyme spectrum in patients with acute non-ST-segment elevation myocardial infarction (NSTEMI). Methods 128 patients with highly suggestive of acute NSTE-ACS were divided into two groups according to final diagnosis including 76 cases of NSTEMI group, 52 cases of UA group. The levels of serum cTnT, AST/LDH/CK/CK-MB were detected in 128 patients and 50 healthy people. Results The level of serum cTnT and myocardial enzyme spectrum in NSTEMI group and UA group were higher than those in healthy controls (P<0.05), and these indicators in NSTEMI group were also higher than those in UA group ( <0.05). The level of serum cTnT was positively cor elative with the levels of AST/LDH/CK/CK-MB among the NSTEMI patients ( <0.05).The diagnosis positive rate of combination detection of cTnT and myocardial enzyme spectrum was significantly higher than that of myocardial enzyme spectrum alone for the patients admission time less than <5h and 5~10h ( <0.05). Conclusion Combination detection of myocardial enzyme spectrum and cTnT can decrease the misdiagnosis and missed diagnosis in the process of diagnosis and treatment, improve the early diagnostic rate of NSTEMI.