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目的:探讨床边快速心肌肌钙蛋白Ⅰ(cTnI)、肌红蛋白(Myo)和肌酸激酶同功酶(CK-MB)联合检测对急性心肌梗死(AMI)早期诊断的价值。方法:采用美国博适—Triage干式快速定量心肌梗死/心衰诊断仪,对急诊收治入院的46例急性胸痛病人,采静脉血动态测定cTnI、Myo和CK-MB含量,并结合临床症状、心电图动态变化综合分析。结果:对AMI诊断的敏感性:0～3hcTnI与CK-MB均为29.4%,低于Myo的47.1%,4～6hcTnI为80.0%,其余均为100.0%;对AMI诊断的特异性:cTnI、CK-MB各时间段均为100.0%,Myo0～3h为58.8%、4～6h为40.0%、12h以上为33.3%;三项联合检测0～3h的敏感性和特异性分别是35.3%和86.3%,4～6h为93.3%、80.0%、12h以上为100.0%、77.8%。结论:床边快速cTnI、Myo和CK-MB联合检测,有助于对AMI床边快速早期诊断和鉴别诊断,为AMI及时准确的治疗提供依据。
Objective: To investigate the value of cTnI, Myo and CK-MB in the early diagnosis of acute myocardial infarction (AMI). Methods: Forty-six patients with acute chest pain admitted to the emergency department were enrolled in this study. The levels of cTnI, Myo and CK-MB in the venous blood were determined by the Bortez-Tiant dry quantitative myocardial infarction / heart failure diagnostic system. Combined with clinical symptoms, Comprehensive analysis of the dynamic changes of ECG. Results: The diagnostic sensitivity to AMI was 29.4% for 0-3hcTnI and CK-MB, lower than 47.1% for Myo, 80.0% for 4 ~ 6 hcTnI and 100.0% for others. The specificity of diagnosis for AMI was cTnI, The time course of CK-MB was 100.0%, Myo 0 ~ 3h 58.8%, 4 ~ 6h 40.0%, 12h more than 33.3%. The sensitivity and specificity of the three combined tests were 35.3% and 86.3 %, 4 ~ 6h 93.3%, 80.0%, 100.0% over 12h, 77.8%. Conclusion: The combination of rapid detection of cTnI, Myo and CK-MB at the bedside is helpful for rapid early diagnosis and differential diagnosis of AMI bed and provide the basis for timely and accurate AMI treatment.