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[目的]探讨心肌坏死标志物联合检测对于急性心肌梗塞早期诊断及鉴别诊断的应用价值。[方法]依据国际心脏病协会和1979年世界卫生组织(WHO)制定的标准,将临床确诊的40例心肌缺血症状的患者划为A组,40例症状不典型的患者划为B组,40例无症状的健康体检者划为C组,作为对照组。电泳检测血清中天门冬氨酸氨基转移酶(AST),肌酸激酶(CK)和乳酸脱氢酶(LDH)的活性,以及血清中心肌钙蛋白I(cTnI),MMB和肌红蛋白(MYO)含量。将检测的结果与临床诊断进行对照回顾分析。[结果]急性心肌梗死早期患者的血清cTnI、MMB、MYO含量、AST、CK及LDH活性,与对照组比较差异有统计学意义(P﹤0.05)。与对照组比较,症状不典型组患者的血清中cTnI、MMB和MYO含量明显增高,AST、CK及LDH活性增高(P﹤0.05);但与例急性心肌梗死早期患者比较,血清中cTnI、MMB、MYO含量和CK活性升高明显,而AST和LDH活性下降明显(P﹤0.05)。[结论]心肌坏死标志物血清联合检测无论在急性心肌梗死早期诊断,还是明确诊断之后的治疗过程中,都有重要的临床意义。
[Objective] To investigate the value of combined detection of myocardial necrosis markers in the early diagnosis and differential diagnosis of acute myocardial infarction. [Methods] According to the criteria established by the International Association of Cardiology and the World Health Organization (WHO) in 1979, 40 clinically diagnosed patients with myocardial ischemia were divided into group A, 40 patients with atypical symptoms were classified as group B, 40 asymptomatic health examination were classified as C group, as a control group. The activity of aspartate aminotransferase (AST), creatine kinase (CK) and lactate dehydrogenase (LDH), as well as serum cTnI, MMB and myoglobin (MYO) )content. The test results and clinical diagnosis of controlled retrospective analysis. [Results] The serum levels of cTnI, MMB, MYO, AST, CK and LDH in the early stage of acute myocardial infarction were significantly different from those in the control group (P <0.05). Compared with the control group, the serum levels of cTnI, MMB and MYO were significantly increased and the activities of AST, CK and LDH were increased in patients with atypical symptoms (P <0.05). However, compared with the patients with acute myocardial infarction, the levels of cTnI, MMB , MYO content and CK activity increased significantly, while AST and LDH activity decreased significantly (P <0.05). [Conclusion] The combined detection of serum markers of myocardial necrosis has important clinical significance both in the early diagnosis of acute myocardial infarction and in the treatment after definite diagnosis.