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目的:探讨心肌肌钙蛋白I(cTnI)对急性心肌梗死(AMI)的早期诊断价值。方法:对38例AMI患者、35例不稳定性心绞痛(UAP)患者、26例骨骼肌损伤(SM)患者和25例健康者进行血清cTnI、CK-MB(肌酸磷酸激酶同工酶)测定,并对AMI患者胸痛发生不同时段cTnI、CK-MB值进行动态观测。结果:AMI患者入院时cTnI、CK-MB的阳性检出率分别为68.5%和56.3%。CK-MB在UAP组和SM组有较高的阳性率,而cTnI在UAP和SM组未检出。cTnI在AMI发生4h内即显著升高,两项指标的最高峰值在8~16h内均可出现,72h后CK-MB降至临界值,而cTnI在7d后仍高于对照组。结论:cTnI在AMI早期具有重要的诊断价值,因其具有较宽的时间诊断窗口和独特的特异性,所以是AMI早期诊断较敏感和特异的血清标志物。
Objective: To investigate the value of cardiac troponin I (cTnI) in the early diagnosis of acute myocardial infarction (AMI). Methods: Serum levels of cTnI and CK-MB (creatine phosphokinase isoenzymes) were measured in 38 patients with AMI, 35 patients with unstable angina pectoris (UAP), 26 patients with skeletal muscle injury (SM) and 25 healthy controls The dynamic changes of cTnI and CK-MB in AMI patients during different periods of chest pain were observed. Results: The positive rates of cTnI and CK-MB in patients with AMI were 68.5% and 56.3% respectively. CK-MB had a higher positive rate in UAP group and SM group, while cTnI was not detected in UAP group and SM group. cTnI increased significantly within 4 hours of AMI. The highest peak value of both indexes appeared in 8 ~ 16 hours. After 72 hours, CK-MB decreased to the critical value, while cTnI was still higher than control group after 7 days. Conclusion: cTnI has important diagnostic value in the early stage of AMI. Because it has a wide time window and unique specificity, cTnI is a sensitive and specific serum marker for early diagnosis of AMI.