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目的分析高敏肌钙蛋白在急性心肌梗死(AMI)患者临床诊断中的应用价值,为临床诊断提供参考。方法选取沧州市盐山县人民医院在2014年3月—2015年2月收治的AMI患者120例为研究对象,在入院后0、4、12 h抽取静脉血;另外选取同期来院体检者70例为对照组,清晨抽取静脉血,两组均测定血清高敏肌钙蛋白(hs-c Tn T)、肌红蛋白(Myo)、普通肌钙蛋白(c Tn T)和肌酸激酶同工酶(CK-MBmass)水平并进行比较。结果 AMI患者各指标含量显著高于对照组(均P<0.05),入院时检测hs-c Tn T、CK-MBmass、Myo、c Tn T阳性率分别为90.8%、75.0%、72.5%、80.0%,并且hs-c Tn T在不同时间点的阳性检出率均值最高,4 h后阳性检出率达到100.0%,此时CK-MBmass(83.3%)、Myo(75.0%)、c Tn T(87.5%),hs-c Tn T检测值从入院后,不同时间浓度测定有明显提高(P<0.05),阳性率也在不断提高。hs-c Tn T阳性预测值为89%,敏感性(91%)显著高于CK-MBmass(75%)、Myo(87%)和c Tn T(80%)(P<0.05)。结论急性AMI患者hs-c Tn T具有很高的敏感性,特异性较高,可以作为鉴别诊断指标之一,在无法开展hs-c Tn T情况下,可以考虑联合c Tn T和Myo检测。
Objective To analyze the clinical value of high-sensitivity troponin in the diagnosis of acute myocardial infarction (AMI) and provide reference for clinical diagnosis. Methods A total of 120 patients with AMI admitted to Yanshan County People’s Hospital of Cangzhou City from March 2014 to February 2015 were enrolled in this study. Venous blood was drawn at 0,4 and 12 h after admission. Another 70 patients As control group, venous blood samples were collected in the early morning, serum hs-c Tn T, myoglobin, cTn T and creatine kinase isoenzymes CK-MBmass) levels and compared. Results The positive rates of hs-c Tn T, CK-MBmass, Myo and c Tn T in admission to hospital were significantly higher than those in the control group (all P <0.05). The positive rates were 90.8%, 75.0%, 72.5% %, And the positive detection rate of hs-c Tn T was the highest at different time points. After 4 h, the positive detection rate was 100.0%. At this time, CK-MBmass (83.3%), Myo (75.0%), cTn T (87.5%). The measured values of hs-cTn T increased significantly at different time points after admission (P <0.05), and the positive rate was also increasing. The positive predictive value of hs-c Tn T was 89%, and the sensitivity (91%) was significantly higher than that of CK-MBmass (75%), Myo (87%) and cTn T (80%). Conclusion The hs-c Tn T in patients with acute AMI is highly sensitive and specific, which can be used as one of the differential diagnosis indicators. In the absence of hs-c Tn T, the combination of cTn T and Myo can be considered.