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目的 :比较心脏标记物肌钙蛋白 I(CTn I) ,肌红蛋白 (Myo)在急性心肌梗死 (AMI)的动态变化 ,以探讨其诊断价值。方法 :用固相双位点化学发光酶联免疫测定法测定了 13例 AMI患者 (5例溶栓再通、8例未溶栓 ) CTn I,Myo并与 CK- KB进行比较。结果 :1溶栓与未溶栓组 CTn I在 AMI胸痛后升高时间较 CK- MB早 (均 P<0 .0 1) ,但以Myo升高时间最早 ;溶栓成功组 CK- MB,CTn I和 Myo升高时间均较未溶栓组提前 (均 P<0 .0 5 ) ;2溶栓与未溶栓组 Myo达高峰时间较 CTn I和 CK- MB均早 (均 P<0 .0 1) ,但 CTn I与 CK- MB达高峰时间相比无显著性差异 (P>0 .0 5 ) ;溶栓再通组 CK- MB,CTn I及 Myo达高峰时间均较未溶栓组提前 (均 P<0 .0 5 ) ;3CK- MB,CTn I和 Myo3种生化标记物以 Myo最早恢复正常 ,而以 CTn I在血清中持续时间最长。结论 :Myo和 CTn I在 AMI早期诊断中有应用价值 ,CK- MB,CTn I及 Myo3者结合可以提高对 AMI诊断的准确性。
Objective: To compare the dynamic changes of cardiac markers CTn I and Myo in acute myocardial infarction (AMI) to explore its diagnostic value. Methods: Thirteen AMI patients (5 thrombolytic recanalization, 8 non-thrombolysis) CTn I and Myo were measured by solid-phase two-site chemiluminescence enzyme-linked immunoassay and compared with CK-KB. Results: 1 CTn I in thrombolytic and non-thrombolytic group increased faster than CK-MB after AMI (all P <0.01) CTn I and Myo increased earlier than those without thrombolytic therapy (all P <0.05). The peak time of Myo in both thrombolysis and non-thrombolysis groups was earlier than CTn I and CK-MB (all P <0 .0 1). However, there was no significant difference between peak CTn I and CK-MB (P> 0.05); peak time of CK-MB, CTn I and Myo in thrombolysis recanalization group were all less (All P <0.05). The biochemical markers of 3CK-MB, CTn I and Myo were the earliest to normal in Myo, and the longest in CTn I in serum. Conclusion: Myo and CTn I have clinical value in the early diagnosis of AMI. The combination of CK-MB, CTn I and Myo 3 can improve the diagnostic accuracy of AMI.