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目的探讨心肌肌钙蛋白Ⅰ(cTnI)和肌红蛋白(MB)对急性心肌梗死(AMI)的诊断价值。方法对192例AMI患者、50例健康对照者和100例非AMI胸痛患者进行血清cTnI和MB检测,并对结果进行统计学分析。结果 AMI患者cTnI和MB较其他两组对照均显著升高(P<0.01),健康对照组和非AMI胸痛组之间差异无统计学意义(P>0.05)。cTnI在AMI胸痛发作12~24 h达到高峰,峰值为(9.68±2.64)μg/L;MB在AMI胸痛发作4~8 h达到高峰,峰值为(378.6±198.6)μg/L。cTnI和MB对AMI诊断灵敏度在AMI发作0~4 h和3~7 d均有显著性差异,4 h~2 d诊断灵敏度无显著性差异,在健康对照组中cTnI和MB对AMI诊断特异度分别为98.0%和84.0%,非AMI胸痛组cTnI和MB对AMI诊断特异度分别为97.0%和74.0%。结论 cTnI诊断AMI具有很高的特异性和较宽的诊断时间,MB对于AMI的早期诊断具有很高的敏感性,两者结合可提高AMI的诊断率,为梗死时间提供必要的信息。
Objective To investigate the diagnostic value of cardiac troponin Ⅰ (cTnI) and myoglobin (MB) in patients with acute myocardial infarction (AMI). Methods Serum samples of cTnI and MB were detected in 192 patients with AMI, 50 healthy controls and 100 patients with non-AMI chest pain. The results were statistically analyzed. Results The cTnI and MB in AMI patients were significantly higher than those in the other two groups (P <0.01). There was no significant difference between healthy control group and non-AMI chest pain group (P> 0.05). cTnI peaked at 12-24 h after onset of chest pain in AMI, with a peak of (9.68 ± 2.64) μg / L; MB peaked at 4-8 h after AMI onset of chest pain (378.6 ± 198.6) μg / L. The diagnostic sensitivities of cTnI and MB to AMI were significantly different between 0-4 h and 3-7 d after AMI and no significant difference between 4 h and 2 d. The sensitivity of cTnI and MB to the diagnosis of AMI in healthy control group 98.0% and 84.0% respectively. The specificity of cTnI and MB for AMI in non-AMI chest pain group was 97.0% and 74.0% respectively. Conclusions The diagnosis of AMI by cTnI has a high specificity and a wide range of diagnostic time. MB is highly sensitive to the early diagnosis of AMI. The combination of the two can improve the diagnostic rate of AMI and provide the necessary information for the infarction time.