血清肌钙蛋白I心肌酶谱对急性心肌梗死诊断价值的对比分析.docVIP

血清肌钙蛋白I与心肌酶谱对急性心肌梗死诊断价值的对比分析 郭敏 （江苏省连云港市第二人民医院检验科，江苏 连云巷 222023） 【摘要】目的 观察比较血清心肌肌钙蛋白I（cTnI）与心肌酶谱[肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）]对急性心肌梗死（AMI）的诊断价值。方法 用化学发光酶免法分别测定50例AMI患者和48例稳定型心绞痛（SA）患者胸痛发作3～24h内cTnI含量，并与80例非AMI患者、45例健康对照组进行比较。同时用全自动生化分析仪测定相应的心肌酶谱。结果 AMI患者组cTnI阳性率为100%，非AMI患者组阳性率为0。而AMI患者组心肌酶谱阳性率分别为CK 74%、CK-MB 70%、LDH 90%，且非AMI组三个酶的阳性率均大于SA组。结论 诊断AMI，血清cTnI较心肌酶谱更特异、更敏感。 ?【关键词】血清心肌肌钙蛋白；心肌酶谱；急性心肌梗死；化学发光酶免法 中图分类号：R542.2+2 文献标识码：B Comparative Analysis of Serum Myocardial Enzyme Assays and Cardiac Troponin Ⅰin the Diagnosis of Acute Myocardial Infarction GUO Min (Department of Laboratory, Lianyungang Second People’s Hospital, Lianyungang 222023, China) [Abstract] Objective To compare serum cardiac troponin I(cTnI) and myocardial enzyme assays which include creatine kinase (CK), creatine kinase MB (CK-MB) and lactate dehydrogenase (LDH) in the diagnosis of acute myocardial infarction (AMI). Methods Detected cTnIlevels of 50 cases of AMI and 48 cases of stable angina (SA) patients with chest pain within 3~24h and 80 cases with non-AMI patients and 45 healthy controls by chemiluminescence enzyme immunoassay method and compared the results. As well as measured corresponding myocardial enzyme assays automatic biochemistry analyzer. Results AMI patients were cTnI positive rate was 100%, non-AMI patients was positive rate was 0. The positive rate of AMI patients were myocardial enzymes assays were CK74%, CK-MB70%, LDH90%, and non-AMI group of three enzymes were higher than SA group. Conclusion The diagnosis of AMI, serum cTnI is more specific than the enzyme, and more sensitive. [Key words]Cardiac troponinI; Serum creatine kinase; Acute myocardial infarction; Chemiluminescence enzyme immunoassay 肌钙蛋白I（troponin，TnI）和TnC、TnT组成的复合物Tn是肌肉收缩的一种调节蛋白。心肌和骨骼肌的肌钙蛋白的复合体均由T、C和I 3种亚单位组成，但血清心肌肌钙蛋白I（cTnI）亚单位的结构肽链N端比其他组织来源的骨骼肌ThI多31个氨基酸，且氨基酸序列不同，因而被认为具有高度心肌特异性[1]。急性心肌梗死（AMI）患者由于心肌供血不足，细胞受损破坏，细胞内容物渗出进入血循环，血清乳酸脱氢酶（LDH）、肌酸激酶（CK）及其同功酶（CK-MB）作为上述标志物已被应用于临床多年，不足之处是心肌酶组织特异性不高，酶活性检测精确