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目的:探讨心肌坏死标志物联合检测在急性心肌梗死早期诊断及鉴别中的意义。方法:选取2010年12月至2013年5月我院收治的90例患者,45例确诊急性心肌梗死患者为观察组,其余45例非急性心肌梗死患者为对照组。分别采集两组患者静脉血4 m L用于检验。采用免疫抑制法测定患者血清中肌酸激酶(CK)和肌酸激酶同工酶(CK-MB)含量,采用电化学发光法检测肌钙蛋白I(c Tn I)和肌红蛋白(MYO)含量。观察并比较不同时间点两组患者血清中CK、CK-MB、c TnⅠ及MYO含量的变化情况。结果:与对照组比较,观察组的血清CK、CK-MB、c TnⅠ及MYO的含量明显升高,其中CK及MYO升高最为显著,差异具有统计学意义(P<0.05)。CK、CK-MB在发病3~6 h后快速升高,24 h达高峰;c TnⅠ前24 h与CK-MB同步,但维持时间较长;MYO在发病后1~2 h发生异常,12 h达峰值(P<0.05)。结论:心肌坏死标志物联合检测可提高急性心肌梗死的检出率,有助于疾病的及时发现、诊断和治疗。
Objective: To explore the significance of combined detection of myocardial necrosis markers in the early diagnosis and differential diagnosis of acute myocardial infarction. Methods: 90 patients admitted from December 2010 to May 2013 in our hospital, 45 patients diagnosed as acute myocardial infarction were selected as observation group, and the remaining 45 patients with non-acute myocardial infarction as control group. Two groups of patients were collected venous blood 4 m L for testing. Serum creatine kinase (CK) and creatine kinase MB (CK-MB) were measured by immunosuppressive assay. The levels of troponin I (cTn I) and myoglobin (MYO) content. The levels of serum CK, CK-MB, cTnI and MYO in two groups at different time points were observed and compared. Results: Compared with the control group, the levels of serum CK, CK-MB, cTnI and MYO in the observation group were significantly increased, and the CK and MYO increased most significantly in the observation group (P <0.05). CK and CK-MB increased rapidly from 3 h to 6 h after onset and peaked at 24 h. Simultaneous with CK-MB in 24 h before cTnⅠ, the maintenance time was longer; MYO occurred 1 to 2 h after onset, and 12 h peak (P <0.05). Conclusion: The combined detection of myocardial necrosis markers can improve the detection rate of acute myocardial infarction, contribute to the timely detection, diagnosis and treatment of the disease.