资源描述:
《血清cTnI、CKMB和Mb浓度动态变化对急性心肌梗死的诊断价值》由会员上传分享,免费在线阅读,更多相关内容在工程资料-天天文库。
1、血清cTnI、CKMB和Mb浓度动态变化对急性心肌梗死的诊断价值【摘要】目的探讨血清心肌肌钙蛋白I(cTnl)、肌酸激酶同工酶(CKMB)和肌红蛋白(Mb)浓度的动态变化对急性心肌梗死(AMI)的诊断价值。方法釆用ELISA法检测了40例AMI病人不同时间血清cTnT.CKMB和Mb浓度的变化,同时对血清cTnT.CKMB和Mb浓度进行了受试者工作特征曲线(ROC)分析。以40例健康查体者作对照。结果AMI病人胸痛发作后不同时间的血清cTnl、CKMB浓度明显高于对照组(F二72.679、109.768,q二3・049〜27.652,P<0
2、.01),且胸痛发作后不同时间浓度比较,差异有显著性(q二2.863〜22.133,P<0.05>0.01);胸痛发作后3~6h、1d血清Mb浓度明显高于对照组、胸痛发作后3d和7d(F=17.729,q二6.175〜&688,P<0.01)o且cTnl、CKMB对诊断AMI的灵敏度、特界度、准确度、约登指数、阳性预测值(PPV)和阴性预测值(NPV)明显高于Mb。AMT病人胸痛发作后3~6h血清CKMB对诊断AMI的准确度高于cTnl和Mb,1d、3d血清CKMB与cTnl诊断AMI的准确度相同,但优于Mb,而胸痛发作后7d时cTn
3、l对AMI诊断的准确度明显优于CKMB。AMI病人胸痛发作后3~6h和1d时cTnKCKMB的AUCROC高于Mb,7d时cTnl的AUCROC高于CKMB,且不同时间的cTnl和CKMB的AUCROC均大于0.9。结论血清cTnl、CKMB和Mb浓度的动态变化对AMI具有明显的诊断价值和较高的准确度。【关键词】心肌梗死肌钙蛋白肌酸激酶肌红蛋白实验室技术和方法[ABSTRACT]ObjectiveToassessthevalueofdynamicchangesofserumcreatinekinaseisoenzyme(CKMB),cardiac
4、troponinI(cTnl),andmyoglobin(Mb)inthediagnosisofacutemyocardialinfarction(AMI).MethodsTheserumcTnl,CKMBandMbof40patientswithAMIatdifferenttimeweredeterminedbyenzymelinkedimmunosorbentassay,40healthysubjectsserveredascontrols・TheserumcTnl,CKMBandMbwereanalyzedbyreceiveroperati
5、ngcharacteristic(ROC)curve・RosultsTheserumcTni,CKMBandMbconcentrationofAMIpatientsaftertheonsetofchestpainatdifferenttimewashigherthanthatofthecontrols(F二72.679,109.768;q二3.049-27.652;P<0.01),andthedifferenceoftheconcentrationsatdifferenttimeafterchestpainwassignificant(q=
6、2.863-22.133;P<0.05,0.01).TheserumMbat3-6hafterchestpainwassignificantlyhigherthanthatofafter3and7days(F二17.729,q二6.175-8・68&P<0・01).CKMbandcTnTweresuperiortoMbinthediagnosisofAMIintermsofsensitivity,specificity,accuracy,Yuedengindex,positivepredictivevalue(PPV)andnegat
7、ivepredictivevalue(NPV).ThediagnosticaccuracyofserumCKMBwashigherthancTnlandMbafter3to6hofchestpain.ThediagnosticaccuracyofserumcTnlandCKMBof1and3dayswassame,butbetterthanMb.TheaccuracyofdiagnosisofcTnlforAMIwasbetterthanCKMBat7dayslaterofchestpain.TheareaundertheROCcurve(AUC
8、ROC)ofCKMBandcTnlwashigherthanMb,whenchestpainonsetafter3~6hand1d.Th