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目的研究高敏肌钙蛋白Ⅰ(hs-cTnⅠ)、肌钙蛋白Ⅰ(cTnⅠ)联合常规心肌标志物在微小心肌损伤(MMD)早期诊断中的应用价值。方法测定172例胸痛患者血清hs-cTnⅠ、cTnⅠ及肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、肌红蛋白(Mb)、超敏C反应蛋白(hs-CRP)等常规心肌标志物的水平。MMD组中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。另选取80例健康体检者作为对照组。结果观察组早期血清各项指标水平及阳性率均明显高于对照组,差异有统计学意义(P<0.05)。hs-cTnI联合4项指标检测阳性率为99.4%,高于cTnI的阳性率94.8%,差异有统计学意义(P<0.05)。MMD组患者各项指标水平均高于非缺血性胸痛(NICP)组和对照组,差异有统计学意义(P<0.05)。STEMI组患者各项指标水平最高。结论早期诊断MMD中,血清hs-cTnI比cTnI更敏感,多项指标联合检测有重要临床意义。
Objective To investigate the value of hs-cTn Ⅰ, cTn Ⅰ combined with routine myocardial markers in the early diagnosis of micro-myocardial injury (MMD). Methods The serum levels of hs-cTnⅠ, cTnⅠ, creatine kinase (CK), creatine kinase MB, myoglobin and hs-CRP in 172 patients with chest pain were measured. Conventional levels of myocardial markers. The MMD group included 68 patients with unstable angina pectoris (UA), 45 with non-ST-segment elevation myocardial infarction (NSTEMI) and 34 with ST-segment elevation myocardial infarction (STEMI). Another 80 healthy people as the control group. Results The early serum levels and positive rates of the observation group were significantly higher than those of the control group, the difference was statistically significant (P <0.05). The positive rate of hs-cTnI combined with 4 indexes was 99.4%, higher than that of cTnI (94.8%), the difference was statistically significant (P <0.05). The level of each index in MMD group was higher than that in non-ischemic chest pain (NICP) group and control group, the difference was statistically significant (P <0.05). STEMI patients with the highest level of the indicators. Conclusion In the early diagnosis of MMD, serum hs-cTnI is more sensitive than cTnI, and the combined detection of multiple indexes has important clinical significance.