李海波

【摘要】 目的：探究超敏肌鈣蛋白I（hs-TnI）和肌酸激酶同工酶（CK-MB）联合检测对急性心肌梗死（AMI）的诊断价值。方法：选择2019年1-12月于笔者所在医院就诊的AMI患者100例作为研究组，同期100例健康体检者作为对照组，采用化学方法光对研究对象进行hs-TnI和CK-MB检测，比较两组上述检测指标的差异及hs-TnI和CK-MB联合检测对AMI的诊断价值。结果：研究组各时间段hs-TnI和CK-MB水平均高于对照组，差异均有统计学意义（P<0.05）。研究组hs-TnI水平于心肌梗死后1～6 h开始升高，13～24 h达到高峰，2～3 d后逐渐下降，但依然维持在较高水平;CK-MB水平于心肌梗死后1～6 h开始升高，13～24 h达到高峰，2～3 d后水平可达正常参考区间。hs-TnI升高窗口期长于CK-MB。研究组1～6 h、7～12 h、13～24 h、2～3 d hs-TnI阳性率分别为92.0%、97.0%、99.0%、77.0%，窗口期长;上述不同阶段CK-MB阳性率分别为25.0%、57.0%、85.0%、12.0%，窗口期短。二者联合诊断AMI的敏感度为85.0%，特异度为99.0%。结论：AMI后hs-TnI和CK-MB明显升高，二者联合检测对AMI的诊断具有重要意义。

【关键词】 超敏肌钙蛋白Ⅰ 肌酸激酶同工酶 急性心肌梗死 诊断

doi：10.14033/j.cnki.cfmr.2020.26.030 文献标识码 B 文章编号 1674-6805（2020）26-00-03

The Value of Combined Detection of High Sensitive Troponin Ⅰ and Creatine Kinase Isoenzyme in the Diagnosis of AMI/LI Haibo. //Chinese and Foreign Medical Research， 2020， 18（26）： -83

[Abstract] Objective： To explore the diagnostic value of high sensitive troponin I （hs-TnI） and creatine kinase isoenzyme （CK-MB） in acute myocardial infarction （AMI）. Method： From January 2019 to December 2019， 100 AMI patients in our hospital were selected as the study group and 100 healthy people were selected as the control group. The quality of hs-TnI and CK-MB were detected by chemical method light. The difference of the above detection indexes between the two groups and the diagnostic value of hs-TnI and CK-MB quality combined detection were compared. Result： The levels of hs-TnI and CK-MB in the study group were higher than those in the control group， the differences were statistically significant （P<0.05）. The hs-TnI level in the study group began to increase at 1-6 h after myocardial infarction， reached a peak at 13-24 h， and gradually decreased at 2-3 d， but still remained at a high level. The level of CK-MB began to rise at 1-6 h after AMI， reached a peak at 13-24 h， and reached a normal reference range at 2-3 days. The window period of hs-TnI elevation was longer than that of CK-MB. The positive rate of hs-TnI at 1-6 h， 7-12 h， 13-24 h， 2-3 d in the study group were 92.0%， 97.0%， 99.0%， 77.0%， with long window period， the positive rate of CK-MB at the same stages were 25.0%， 57.0%， 85.0% and 12.0%， respectively， with short window period. The sensitivity and specificity of hs-TnI positive rate were 85.0% and 99.0% respectively. Conclusion： hs-TnI and CK-MB are significantly increased after AMI. The combined detection of hs-TnI and CK-MB is of great significance for the diagnosis of AMI.

[Key words] High sensitive troponin I Creatine kinase isoenzyme Acute myocardial infarction Diagnosis

First-authors address： Wuchuan Peoples Hospital， Wuchuan 524500， China

急性心肌梗死（AMI）是心血管领域致死和致残的主要疾病之一，其发病急、进展快，需要迅速干预。在发病的不同时期某些生物标志物能够出现血清浓度变化，有助于AMI的诊断和治疗[1]。超敏肌钙蛋白I（hs-TnI）对心肌损伤具有较高特异性，在心肌缺血的早期心肌细胞质游离的hs-TnI可以迅速释放至血液中[2]。肌酸激酶同工酶（CK-MB）对于再发心肌梗死或溶栓再通具有很强的标志作用，但并非心肌细胞特有，对于心肌损伤的敏感性强[3]。hs-TnI联合CK-MB检测可以提高AMI诊断的敏感性和特异性。因此为探究hs-TnI和CK-MB联合检测对AMI的诊断价值进行本研究，现将结果报告如下。

1 资料与方法

1.1 一般资料

选择2019年1-12月于笔者所在医院就诊的AMI患者100例作为研究组，纳入标准：经过冠状动脉造影明确诊断AMI;年龄>18周岁。排除标准：严重的肾脏功能不全;合并其他原因导致的心肌损伤;合并主动脉夹层、肺动脉栓塞;近3 d剧烈运动。选择同期100例健康体检者作为对照组。研究组男67例，女33例;年龄44～73岁，平均（57.3±7.3）岁。对……