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目的 探讨心肌肌钙蛋白 (CTnⅠ )在诊断急性心肌梗死 (AMI)和不稳定心绞痛 (UAP)的应用价值。方法 对 31例AMI和 4 0例不稳定心绞痛 (UAP)病人进行血清CTnⅠ、肌酸激酶 (CK)和肌酸激酶同功酶 (CK MB)检测 ,并进行两组间比较分析。结果 31例AMI病人中 2 9例病人血清CTnⅠ明显升高 ,4 0例UAP病人中仅 2例血清CTnⅠ轻度升高。血清CTnⅠ诊断AMI的敏感性为 96 7% ,而CK和CK MB的敏感性分别为 80 %、80 %。血清CTnⅠ诊断AMI的特异性为 94 4 % ,而CK MB的特异性为 77 7%、77 7%。CTnⅠ的敏感性和特异性显著高于CK和CK MB(P <0 0 1)。结论 心肌肌钙蛋白Ⅰ对于AMI的诊断具有很高的敏感性和特异性 ,能早期诊断AMI。此外 ,CTnⅠ在鉴别急性心肌梗死和不稳定心绞痛也具有重要的临床价值 ,心肌肌钙蛋白Ⅰ是一种心肌损伤的特异性标志物。
Objective To investigate the value of myocardial troponin (CTnⅠ) in the diagnosis of acute myocardial infarction (AMI) and unstable angina pectoris (UAP). Methods Serum levels of CTn Ⅰ, creatine kinase (CK) and creatine kinase CK (CK MB) in 31 patients with AMI and 40 patients with unstable angina pectoris (UAP) were measured and compared between the two groups. Results Serum CTnⅠ in 29 AMI patients was significantly higher than that in 29 AMI patients. Only 2 of 40 UAP patients had a slight increase in serum CTn Ⅰ. The sensitivity of serum CTnI in diagnosing AMI was 96.7%, while the sensitivity of CK and CK MB was 80% and 80% respectively. Serum CTnI diagnosis of AMI specificity of 94 4%, while the specificity of CK MB was 77 7%, 77 7%. The sensitivity and specificity of CTnI were significantly higher than those of CK and CK MB (P <0.01). Conclusions Cardiac troponin I is highly sensitive and specific for the diagnosis of AMI and can be used for the early diagnosis of AMI. In addition, CTnI in the identification of acute myocardial infarction and unstable angina also has important clinical value, cardiac troponin Ⅰ is a specific marker of myocardial injury.