三项心肌标志物在各类型冠心病诊断中的应用及评价

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目的了解3项心肌标志物对急性心肌梗死(AMI)、不稳定心绞痛(UAP)和稳定性心绞痛(SAP)的诊断价值,以资评估。方法心肌肌钙蛋白I(CTnI)和肌红蛋白(Myo)采用荧光抗原抗体法,心肌酶谱(MEP)采用速率法。对67例各类型冠心病(CHD)的血清中CTnI、Myo和“MEP”含量检测,并对结果加以比较和分析。结果 AMI 28例的3项指标异常检出率分别为78.57%、75.00%和85.71%;UAP 20例,异常检出率分别为45.00%、40.00%和20.00%;SAP 19例,3项指标的异常检出率分别为零、零和5.26%。若3项指标在AMI、UAP和SAP患者中异常检出结果各项各组之间互为交叉比较,结果除MEP诊断UAP与SAP结果差异无统计学意义外,其他各项各组结果比较,差异均有统计学意义(P<0.05或P<0.01)。结论 3项心肌标志物各具有特点,对冠心病各类型均有早期诊断和鉴别诊断的意义。3项指标一起用于临床,对急性冠脉综合征(ACS)早期判断、预后、预测、危险分层、风险评估等具有诊断价值。 Objective To investigate the diagnostic value of three myocardial markers for acute myocardial infarction (AMI), unstable angina pectoris (UAP) and stable angina pectoris (SAP). Methods The cardiac troponin I (CTnI) and myoglobin (Myo) were detected by the fluorescent antigen antibody method and the myocardial enzyme spectrum (MEP) by the rate method. The serum levels of CTnI, Myo and “MEP” in 67 cases of various types of coronary heart disease (CHD) were detected, and the results were compared and analyzed. Results The abnormal detection rates of three indexes in 28 cases of AMI were 78.57%, 75.00% and 85.71% respectively. In 20 cases of UAP, the abnormal detection rates were 45.00%, 40.00% and 20.00%, respectively. There were 19 cases of SAP and 3 indexes Anomaly detection rates were zero, zero and 5.26% respectively. If the three indicators in the AMI, UAP and SAP patients with abnormal results across the various cross-comparison between the results, in addition to MEP diagnosis of UAP and SAP results were no significant difference, the results of the other groups compared, The differences were statistically significant (P <0.05 or P <0.01). Conclusion The three myocardial markers have their own characteristics, which have the significance of early diagnosis and differential diagnosis in all types of coronary heart disease. Three indicators for clinical use, acute coronary syndrome (ACS) early judgment, prognosis, prediction, risk stratification, risk assessment has diagnostic value.
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