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目的探讨急性冠脉综合征(ACS)患者血浆肌红蛋白(Mb)、心肌肌钙蛋白I(c Tn I)、肌酸激酶同工酶(CK-MB)和超敏C反应蛋白(hs-CRP)水平变化及其联合检测在诊断ACS中的临床价值。方法选取ACS患者141例(ACS组),冠心病(HD)患者(除外ACS)110例(CHD组),健康体检者150例(健康对照组),其中ACS再分为不稳定型心绞痛(UA)57例(UA组)和急性心肌梗死(AMI)84例(AMI组),分别进行血清Mb、c Tn I、CK、CK-MB和hs-CRP检测。结果 ACS患者血清Mb、c Tn I、CK-MB和hs-CRP检测值均高于CHD组及健康对照组(P<0.05);AMI组各项检测指标水平均高于UA组、CHD组和健康对照组(P<0.05);Mb、c Tn I、CK-MB和hs-CRP联合检测对ACS诊断的阳性率高于只检测其中任意一种指标或两种指标。结论 ACS患者血清Mb、c Tn I、CK-MB和hs-CRP水平明显升高;Mb、c Tn I、CK-MB和hs-CRP联合检测有助于ACS早期快速诊断和鉴别诊断。
Objective To investigate the relationship among the levels of plasma Mb, cTn I, CK-MB and hs- CRP) levels and their clinical value in the diagnosis of ACS. Methods One hundred and eleven patients (ACS group), 110 CHD patients (excluding CHD group) and 150 healthy people (control group) were enrolled in this study. ACS was divided into unstable angina pectoris (UA) ), 57 cases of UA group and 84 cases of acute myocardial infarction (AMI group). Serum Mb, cTn I, CK, CK-MB and hs-CRP were detected respectively. Results The serum levels of Mb, cTn I, CK-MB and hs-CRP in ACS patients were significantly higher than those in CHD group and healthy control group (P <0.05). The levels of AMI index were higher than those in UA group, CHD group and (P <0.05). The positive rates of combined detection of Mb, cTn I, CK-MB and hs-CRP in ACS were higher than those in the control group alone or both. Conclusion The serum levels of Mb, cTn I, CK-MB and hs-CRP in patients with ACS were significantly increased. Combined detection of Mb, cTn I, CK-MB and hs-CRP was helpful for the early diagnosis and differential diagnosis of ACS.