急性心肌梗死血清诊断指标比较技巧.docVIP

急性心肌梗死血清诊断指标比较 临床心血管病杂志 2000年第2期第16卷 临床研究 作者：苏恩本　张寄南　卞智萍　徐晋丹　杨笛　马文珠 单位：苏恩本（南京医科大学第一附属医院心血管研究所(南京，210029)）；张寄南（南京医科大学第一附属医院心血管研究所(南京，210029)）；卞智萍（南京医科大学第一附属医院心血管研究所(南京，210029)）；徐晋丹（南京医科大学第一附属医院心血管研究所(南京，210029)）；杨笛（南京医科大学第一附属医院心血管研究所(南京，210029)）；马文珠（南京医科大学第一附属医院心血管研究所(南京，210029)） 关键词：心肌梗死；肌酸激酶同工酶类；肌钙蛋白 　　摘　要：目的：建立血清磷酸肌酸激酶同工酶MB(CK-MB)与心肌肌钙蛋白I(cTnI)测定的方法，并通过与CK、谷草转氨酶(AST)、乳酸脱氢酶(LDH)比较阐述其对急性心肌梗死(AMI)的诊断价值。方法：共观察急性心肌梗死(AMI)65例，陈旧性心肌梗死28例，稳定性心绞痛17例，阵发性室上性心动过速49例。建立CK-MB单克隆抗体吸附测定与cTnI ELISA双夹心测定的方法。同时观察血清CK-MB、cTnI、CK、AST、LDH在AMI等疾患中的变化。结果：血清CK-MB单克隆抗体吸附法与cTnI ELISA双夹心法回收率分别为97%～113%、94.6%～105.6%，标准曲线相关系数分别为0.993与0.990，分别与琼脂糖电泳法及国外实验室检测法对比结果基本一致。AMI胸痛发生后12 h内血清CK-MB的敏感性最高，12～24 h的敏感性与CK、cTnI相当，高于AST和LDH，而24 h后血清cTnI的敏感性最高；血清CK-MB与cTnI对AMI诊断的特异性和诊断有效性明显高于CK、AST、LDH。结论：血清CK-MB单克隆抗体吸附法与cTnI ELISA双夹心法的敏感性和特异性高，CK-MB与cTnI两个指标相互补充，对诊断AMI有重大的临床价值。 Comparison of serum markers for diagnosis of 　　acute myocardial infarction SU En-ben　ZHANG Ji-nan　BIAN Zhi-ping　XU Jin-dan　YANG Di　MA Wen-zhu 　　(The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029) 　　Abstract：Objective: The methods of measurements of serum CK-MB and cTnI were established. Their value in diagnosis of acute myocardial infarction (AMI) was evaluated comparing to CK, AST and LDH.Method:65 cases of acute myocardine infarction (AMI),28 cases of old myocardial infarction,17 cases of stable angina pectoric and paroxysm supraventricular tachycardia were observed. Assays of CK-MB based on monoclonal antibodies against CK-MB and cTnI with a double monoclonal sandwich ELISA were developed. Changes of serum CK-MB, CK, AST, LDH, cTnI were detected. The values of such serum markers in diagnosis were compared each other.Result: The recovery rate of CK-MB measured with monoclonal antibodies againt CK-MB was 97%～113% while that of cTnI measured with double monoclonal Sandwich ELISA was 94.6%～105.6%. The correlation coefficient of standard curve was 0.993 and 0.990 respectively. The highest sensitivity of serum