肌钙蛋白I联合超敏CRP在急性心肌梗死诊断和预测再梗中的价值

【摘要】目的:探讨肌钙蛋白I(cTnI)和超敏CRP(hsCRP)在急性心肌梗死(AMI)早期诊断和心肌再梗中的价值。方法:测定131例AMI发作2 h血清cTnI、CKMB和hsCRP的浓度，以122健康体检者作对照，并分析受试者工作特征(ROC)曲线。结果:AMI早期血清cTnI、CKMB和hsCRP水平与对照组相比差异均有统计学意义(P<0.01)；cTnI、hsCRP和CKMB三指标串联诊断心肌梗死的敏感度与特异度分别为99.8%和93.6%，优于各单个指标。通过ROC曲线确定再梗的Cutoff值，cTnI为16.8 ng/mL,CKMB为40.5 U/L,hsCRP为38.5 mg/L。高浓度的cTnI和hsCRP对心肌再梗均有一定的预测意义(风险指数分别为5.5和2.9,P值<0.001和0.01)，而cTnI和/或hsCRP联合预测心肌再梗的风险指数高达9.9(P<0.0001)。结论:多种心肌标志物联合可早期快速诊断急性心肌梗死，一定水平的cTnI联合hsCRP检测可早期预测心肌再梗。

【关键词】肌钙蛋白I；超敏C反应蛋白；肌酸激酶同工酶；急性心肌梗死；心肌再梗死

Diagnostic Value of Cardiac TroponinI combined with HsCRP in Acute Myocardial Infarction and in Predicting Myocardial Reinfarction LU Jun,FENG Jing,CAO Feng,XIE Fei,LI Xiandong (Department of Clinical Laboratory,Taihe Hospital,Yunyang Medical College,Shiyan,Hubei 442000,China)

Abstract: Objective To explore the early diagnostic value of cardiac troponinI (cTnI) combined with hsCRP in acute myocardial infarction (AMI) and in predicting myocardial reinfarction.Methods The serum concentrations of cardiac troponinI,CKMB and hsCRP in 131 cases with acute myocardial infarction were measured at 2 h onset,and were compared with 122 normal controls.The results were analyzed with ROC curve.Results Compared with control group,the levels of cTnI,CKMB and hsCRP were significantly higher in AMI group(P<0.01).The sensitivity and specificity of combining cTnI,CKMB and hsCRP was 0.998 and 0.936,respectively.According to ROC curve,the cutoff values of cTnI,CKMB and hsCRP were 16.8 ng/mL,40.5U/L and 38.5mg/L in myocardial reinfarction,respectively.Higher concentration CTnI and hsCRP all played a role in predicting myocardial reinfarction (risk index was 5.5 and 2.9,respectively,P<0.0001 and 0.01),but the risk index was increased to 9.9 when cTnI and hsCRP was combined(P<0.0001).Conclusions Early acute myocardial infarction could be diagnosed by multiplemyocardial marker profiles rapidly,and cTnI combined with hsCRP can effectively predict myocardial reinfarction.

Key words:cTnI;hsCRP;CKMB；Acute myocardial infarction;Reinfarction

作者：吕军, 冯景, 曹峰, 谢飞, 李显东作者单位：郧阳医学院附属太和医院检验科，湖北十堰 442000

幸福检验网感谢作者对论文的分享

急性心肌梗死(Acute myocardial infarction, AMI)是指在冠状动脉病变的基础上,发生冠状动脉血供急剧减少或中断,使相应心肌严重而持久地急性缺血导致坏死，是引起老年人急性死亡的一个重要因素。其临床表现有剧烈而持久的胸痛,血清心肌酶增高,以及心电图特征改变。然而,约25%患者无早期典型临床症状，约半数以上无特异心电图改变[1]。肌钙蛋白I(cTnI)和肌酸激酶同工酶(CKMB)是心肌梗死最常用的标志物，超敏C反应蛋白(hsCRP)作为心肌梗塞的急性时相蛋白受到越来越多的重视,早期检测心肌相关标志物显得格外重要。本研究对cTnI、CKMB和hsCRP进行联合检测，旨在探讨cTnI 联合hsCRP在AMI早期诊断和心肌再梗中的价值。

1 材料和方法

1.1 对象

1.1.1 对照组:郧阳医学院附属太和医院健康体检者122名，其中男77名，女45名,年龄54～70岁,平均年龄（60.3±9.8）岁。肝肾功能、心肌酶、cTnI、hsCRP和心电图正常。无外伤、肌肉病变、心血管疾病、高脂血症、糖尿病和其他内分泌疾病、血肌酐浓度正常者。

临床检验医学网-幸福检验

搜索

热门标签

肌钙蛋白I联合超敏CRP在急性心肌梗死诊断和预测再梗中的价值