山西医科大学学报
山西醫科大學學報
산서의과대학학보
JOURNAL OF SHANXI MEDICAL UNIVERSITY
2001年
z1期
28-30
,共3页
王晋军%李运乾%刘卓敏%王绪太%薛树仁
王晉軍%李運乾%劉卓敏%王緒太%薛樹仁
왕진군%리운건%류탁민%왕서태%설수인
心肌梗死%肌钙蛋白%诊断
心肌梗死%肌鈣蛋白%診斷
심기경사%기개단백%진단
目的 比较研究心肌肌钙蛋白I和T对 急性心肌 梗塞（AMI）的临床诊断应用价值。方法 采用前瞻性双盲随机及平 行对照试验方法，将研究对象分为AMI组和非AMI组。AMI组共有按WHO标准诊断的AMI病人121例，随机分二组分别作肌钙蛋白I(cTnI) 和肌钙蛋白T(cTnT)检查。作cTnI的共62例，作cTnT的59例。非AMI组包括健康人80例及陈旧心肌梗死、心绞痛、肾衰等患者。本法采用单克隆抗体酶联免疫法检测。cTnI和cTnT的正常值均为0.2 mg/L。CK-MB正常为25 U/L。结果 在AMI早期cTnI诊断 敏感性较cTnT为高，胸痛2 h阳性率分别为41.7%和0.0%(P<0.01)。在 AMI中晚期则cTnI较cTnT为低，AMI第10 d阳性率分别为38.7%和62.7%(P<0.05)。连续检测两者敏感性均可达100%(AMI 8～12 h)。各期敏感性均优于CK-MB。在非AMI组cTnT可出现在肾衰病人。cTnI、cTnT和CK-MB诊断AMI特异性无明显差异（P>0.05）。cTnI和cTnT有较高的阴性预测值，它们均可达100% 。血管再通和梗塞部位及有无Q波影响它们在AMI早期的敏感性。结论 cTnI和c TnT是诊断AMI的敏感指标。在AMI早期检测cTnI而中晚期检测cTnT可提高AMI的诊断阳性率。
目的 比較研究心肌肌鈣蛋白I和T對 急性心肌 梗塞（AMI）的臨床診斷應用價值。方法 採用前瞻性雙盲隨機及平 行對照試驗方法，將研究對象分為AMI組和非AMI組。AMI組共有按WHO標準診斷的AMI病人121例，隨機分二組分彆作肌鈣蛋白I(cTnI) 和肌鈣蛋白T(cTnT)檢查。作cTnI的共62例，作cTnT的59例。非AMI組包括健康人80例及陳舊心肌梗死、心絞痛、腎衰等患者。本法採用單剋隆抗體酶聯免疫法檢測。cTnI和cTnT的正常值均為0.2 mg/L。CK-MB正常為25 U/L。結果 在AMI早期cTnI診斷 敏感性較cTnT為高，胸痛2 h暘性率分彆為41.7%和0.0%(P<0.01)。在 AMI中晚期則cTnI較cTnT為低，AMI第10 d暘性率分彆為38.7%和62.7%(P<0.05)。連續檢測兩者敏感性均可達100%(AMI 8～12 h)。各期敏感性均優于CK-MB。在非AMI組cTnT可齣現在腎衰病人。cTnI、cTnT和CK-MB診斷AMI特異性無明顯差異（P>0.05）。cTnI和cTnT有較高的陰性預測值，它們均可達100% 。血管再通和梗塞部位及有無Q波影響它們在AMI早期的敏感性。結論 cTnI和c TnT是診斷AMI的敏感指標。在AMI早期檢測cTnI而中晚期檢測cTnT可提高AMI的診斷暘性率。
목적 비교연구심기기개단백I화T대 급성심기 경새（AMI）적림상진단응용개치。방법 채용전첨성쌍맹수궤급평 행대조시험방법，장연구대상분위AMI조화비AMI조。AMI조공유안WHO표준진단적AMI병인121례，수궤분이조분별작기개단백I(cTnI) 화기개단백T(cTnT)검사。작cTnI적공62례，작cTnT적59례。비AMI조포괄건강인80례급진구심기경사、심교통、신쇠등환자。본법채용단극륭항체매련면역법검측。cTnI화cTnT적정상치균위0.2 mg/L。CK-MB정상위25 U/L。결과 재AMI조기cTnI진단 민감성교cTnT위고，흉통2 h양성솔분별위41.7%화0.0%(P<0.01)。재 AMI중만기칙cTnI교cTnT위저，AMI제10 d양성솔분별위38.7%화62.7%(P<0.05)。련속검측량자민감성균가체100%(AMI 8～12 h)。각기민감성균우우CK-MB。재비AMI조cTnT가출현재신쇠병인。cTnI、cTnT화CK-MB진단AMI특이성무명현차이（P>0.05）。cTnI화cTnT유교고적음성예측치，타문균가체100% 。혈관재통화경새부위급유무Q파영향타문재AMI조기적민감성。결론 cTnI화c TnT시진단AMI적민감지표。재AMI조기검측cTnI이중만기검측cTnT가제고AMI적진단양성솔。
Objective To compare the value be tween cardiac troponin I (cTnI) and T (cTnT) for detection of acute myocardial infarction(AMI). Methods In this prospective, double-blind, randomized, parallel controlled study, the subjects were divided into two: AMI g roup and non-AMI group. There were 121 patients with AMI(WHO Criteria). Serum cTnI and cTnT were measured randomly in the two groups. cTnI in 62 patients with AMI and cTnI in 59 patients with AMI were measured. Non-AMI group included 80 normal subjects, patients w ith old myocardial infarction, angina pectoris, renal failure and so on. The monoclonal enzyme immunoassay test was us ed. The normal range for both cTnI and cTnT was 0.2 mg/L and for c reatine kinase isoenzyme MB(CK-MB) was 25 U/L. Results The sensitivity of cTnI was higher in early period and that of cTnT was better in late period. Sen sitivity of cTnI and cTnT was 41.7% and 0.0% (P<0.01) respectively at h 2 af ter chest pain. It was 38.7% and 62.7% (P<0.05) at d 10 of AMI. Sensitivity of cTnI and cTnT could reach 100% after serial assays (at h 8～10 a fter AMI) and both were better than CK-MB. In a few patients with angina pec toris in n on-AMI group， cTnI and cTnT were positive and these were positive in pati ents with renal failure. There was no significant difference of the specificity among cTnI, cTnT and CK-MB for detection of AMI. Both cTnI and cTnT had high er negative prospective values (to 100%). There were effects of reperfu sion and side of infarction and non-Q infarction on their sensitivit y in early period of AMI. Conclusion Test of both cTnI and cTnT were t he sensitive methods. The results indicate that sensitivity for diagnosis of AMI can be increased if cTnI is tested in early AMI and cTnT in middle and late AMI .
