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目的探讨高敏肌钙蛋白I(hs-cTnI)和常规心肌标志物在微小心肌损伤(MMD)早期诊断中的价值。方法测定172例MMD患者血清hs-cTnI及心肌标志物(CK、CK-MB、hs-CRP、cTnI、Mb)的浓度,根据患者胸痛发作至采血时间分为<3 h组和3 h~6 h组。MMD组包括不稳定型心绞痛(UA)68例、非ST段抬高心肌梗死(NSTEMI)45例,ST段抬高心肌梗死(STEMI)34例。选择80例健康体检者作为对照组。结果观察组检测值、阳性率均明显高于对照组,差异有统计学意义(P<0.05),其中hs-cTnI阳性率最高,为93.6%。胸痛时间3 h~6 h组各项指标水平均高于胸痛时间<3 h组、对照组,各组之间比较差异均有统计学意义(P<0.05)。MMD组中UA、NSTEMI、STEMI患者血清各项指标水平均高于NICP组和对照组,差异有统计学意义(P<0.05)。MMD组中STEMI患者血清各项指标均高于UA和NSTEMI患者,差异有统计学意义(P<0.05)。结论 hs-cTnI是MMD早期诊断的敏感指标,多项指标联合检测对MMD的早期诊断有重要临床意义。
Objective To investigate the value of high-sensitivity troponin I (hs-cTnI) and routine myocardial markers in the early diagnosis of micro-myocardial injury (MMD). Methods The serum levels of hs-cTnI and myocardial markers (CK, CK-MB, hs-CRP, cTnI, Mb) in 172 MMD patients were determined. The patients were divided into 3 h group h group. The MMD group included 68 patients with unstable angina pectoris (UA), 45 patients with non-ST elevation myocardial infarction (NSTEMI) and 34 patients with ST-segment elevation myocardial infarction (STEMI). 80 healthy people were selected as the control group. Results The positive rate of hs-cTnI in the observation group was significantly higher than that of the control group (P <0.05). The positive rate of hs-cTnI was the highest (93.6%). All indexes of chest pain time 3 h ~ 6 h group were higher than that of chest pain time <3 h group, the difference between the control group and each group was statistically significant (P <0.05). The serum levels of UA, NSTEMI and STEMI in MMD group were significantly higher than those in NICP group and control group (P <0.05). The serum markers of STEMI patients in MMD group were higher than those in UA and NSTEMI patients, the difference was statistically significant (P <0.05). Conclusion hs-cTnI is a sensitive indicator of early diagnosis of MMD. Combined detection of multiple indicators has an important clinical significance in the early diagnosis of MMD.