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目的 探讨院外即时检测(point of care test,POCT)肌钙蛋白I在院外急救中对急性心肌梗死(acute myocardial infarction,AMI)的早期诊断价值.方法 收集由本中心3个分站转送的“胸痛”疑似AMI患者在急救车上进行常规心电图(electrocardiograph,ECG)检测及心肌肌钙蛋白I(cardiac troponin I,cTnI)POCT检测,观察检测结果并与院内回访数据相结合,比较单项心电图检查、cTnI检测及二者联合检测的阳性检出率.结果 院外心肌标志物cTnI即时定性检测比心电图法在院外急救“胸痛”患者中对AMI的诊断有明显较高的灵敏度(P=0.00028).在医院确诊的31例AMI患者中,POCT法检测为24例(77%),心电图法检测为15例(48%).结论 在AMI患者的院外急救中引入院外及时检测肌钙蛋白可提高诊断率,缩短诊断时间,适合在院外快速筛选出AMI患者,对AMI早期诊断和再灌注治疗有重要价值,并适用于临床推广.“,”Objective To investigate the value of testing cTnI during pre-hospital care system. Method Comparatively analyzed three methods for AMI fast detecting including ECG, cTnI of POCT and combine usage of ECG and cTnI POCT for suspected AMI patients in pre-hospital emergency care system Result Compared with ECG, cTnI test can improve sensitivity on AMI diagnosis (P=0.00028). Among the 31 cases of AMI patients , 24 cases were detected positive by POCT and 15 cases positive by ECG. Conclusion It is very helpful to introduce cTnI (POCT) test in pre-hospital care system to quick screening out AMI patientsI, by improving diagnostic rate and shortening diagnostic time.