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测定急性心肌梗塞(AMI)病人血清心脏肌钙蛋白I(cTnI)和心肌酶学水平,以探讨其诊断AMI价值.方法:cTnI和心肌酶学分别以固相免疫法析法和酸法测定.结果:50例AMI病人cTnI阳性率98.00%较高血压病[EH]患者(0/21)和正常人(0/43)显著升高(P约<0.0001).31例AMI cTnI高阳性者心肌酶学敏感性83.87%与cTnI近似(P=0.103),而在18例AMI cTnI低阳性者中仅22.22%,较cTnI差异显著(P<0.0001).15例AMI cTnI高阳性者于发病后2天cTnI和心肌酶阳性率较高,7～10天cTnI仍有较高的阳性率(86.67%),但后者显著下降(20.00%)并于10天后恢复正常.cTnI阳性率10d后始明显下降(36.36%),少数持续3周.结论:cTnI诊断AMI具高度特异性和敏感性,对AMI微小心肌损伤和中、晚期诊断cTnI测定优于心肌酶学.
Serum cardiac troponin I (cTnI) and myocardial enzyme levels were measured in patients with acute myocardial infarction (AMI) to investigate the diagnostic value of AMI.Methods: The cTnI and myocardial enzymes were determined by solid phase immunoassay and acid method respectively. Results: The positive rates of cTnI in 50 patients with AMI were significantly higher than those with hypertensive disease [EH] (0/21) and normal subjects (0/43) (P <0.0001) Enzyme sensitivity was 83.87%, which was similar to cTnI (P = 0.103), but only 22.22% among 18 cases with low AMI cTnI, which was significantly different from cTnI (P <0.0001) Day cTnI and myocardial enzyme positive rate of cTnI 7 to 10 days still have a high positive rate (86.67%), but the latter decreased significantly (20.00%) and returned to normal after 10 days.CTnI positive rate was significantly increased after 10d (36.36%) and few continued for 3 weeks.Conclusion: The diagnosis of AMI by cTnI is highly specific and sensitive, and it is superior to myocardial enzymology in the diagnosis of myocardial micro AMI and cTnI.