CTn-I、Mb、CK-MB对心肌梗死辅助诊断.doc

CTn-I、Mb、CK-MB对心肌梗死辅助诊断 　【摘要】 目的 为了进一步检测肌钙蛋白（cardiac troponin-I，CTn-I）、肌红蛋白（myoglobin, Mb）、肌酸激酶同工酶MB(creatine kinase isoenzyme MB,CK-MB)在不同的胸痛持续时间后诊断急性心肌梗死的敏感性和特异性，并与心电图ST段有无改变相对比，以期为怀疑心梗的患者制定最快速的确诊方案。方法 对164例疑为急性心梗患者做了回顾性调查分析，依据入院时胸痛持续时间及有无心电图ST段的抬高分组比较其CTn-I、Mb、CK-MB的阳性率及阴性率，以及在各时段用CTn-I、Mb、CK-MB诊断AMI的敏感性及特异性进行了比较。结果 结果显示在入院时胸痛持续2h内心电图是较好的指标，而在2h后，其敏感性明显地低于上述三个生化指标，在特异性方面则明显不如CTn-I，辅助利用这几项指标可以明显地提高AMI的诊出率（提高23.2%）。结论 在疑为AMI的急诊患者做了心电图检查后，及时做CK-MB、Mb、CTn-I的检查及动态观察能提高确诊率（确定是AMI或非AMI），可以为患者接受及时正确的治疗保障时间。 【关键词】 急性心肌梗死 诊断 CTn-I CK-MB Mb 心电图 【Abstract】 Objective To verify the sensitivity and specificity of serum cardiac troponin-I (CTn-I), creatine kinase isoenzyme MB (CK-MB) and myglobin (Mb) for diagnosis of acute myocardial infarction (AMI) among the patients with different duration of chest pain and suspected to be AMI，and whether CTn-I, CK-MB and Mb have some advantage of improving the accuracy of diagnosis comparing to ECG-ST elevation in sensitivity, upon which an faster and more exact project was hoped to be put on and to be helpful to diagnose AMI. Methods A retrospective study of 164 cases consecutively which had a symptom of chest pain in emergency and suspected to be AMI were conducted, according to the lasted and whether had an elevation of ECG-ST, the patients were grouped, the positive rate and negative rate were compared, meanwhile, the sensitivity and specificity of CTn-I, CK-MB, Mb and ECG-ST among these different groups were also compared.Results The results showed that the item of ECG-ST was the best to the patients with a chest pain lasted less than 2 hours, and along with the time lasted, the sensitivity of ECG-ST was less than Mb, CTn-I and CK-MB, the specificity was less than CTn-I, the results also showed if the Mb, CTn-I and CK-MB were combined, the accuracy of diagnosis would be much improved. Conclusion To the patients of suspicious to be AMI, conducted an examination of Mb, CTn-T and CK-MB timely would improve the accuracy of diagnosis (be