CAJ | 학술논문

目的：探讨胶体金免疫层析法检测血清肌钙蛋白I、肌酸激酶同工酶（CK-MB）、肌红蛋白在急性心肌梗死（AMI）患者早期不同时间段的诊断价值。方法收集该院2011年1月至2012年12月收治的89例AMI病例，根据发病时间分为两组，2～＜6h组42例，6～12h组为47例，非心肌梗死对照组70例。采用血清肌钙蛋白I、CK-MB、肌红蛋白三合一诊断试剂对选取的病例进行测定。结果AMI患者肌钙蛋白I、CK-MB、肌红蛋白的阳性率均高于对照组（P＜0．05），在2～＜6h时间段内三者的敏感度分别为35．7％、64．3％、52．4％，均低于6～12h时间段的48．9％、85．1％、76．6％，结果差异有统计学意义（P＜0．05）。CK-MB用于诊断的敏感度在两个时间段内分别为：64．3％、85．1％，较肌钙蛋白I（35．7％、48．9％）、肌红蛋白（52．4％、76．6％）高，差异有统计学意义（P＜0．05），而肌红蛋白敏感度较肌钙蛋白I高（P＜0．05）。将三者联合测定时，阳性率高于单独测定时的阳性率，2～6h组阳性率为69．0％，6～12h组阳性率为89．4％。结论在AMI早期，肌钙蛋白I、CK-MB、肌红蛋白单独测定阳性率较低，不能满足临床需要，而采用胶体金法心肌三合一诊断试剂盒，对肌钙蛋白I、CK-MB、肌红蛋白进行联合测定能提高AMI的早期诊断阳性率，以便为临床提供可靠的实验信息，及时采取有效的治疗措施，从而降低患者的病死率。
목적：탐토효체금면역층석법검측혈청기개단백I、기산격매동공매（CK-MB）、기홍단백재급성심기경사（AMI）환자조기불동시간단적진단개치。방법수집해원2011년1월지2012년12월수치적89례AMI병례，근거발병시간분위량조，2～＜6h조42례，6～12h조위47례，비심기경사대조조70례。채용혈청기개단백I、CK-MB、기홍단백삼합일진단시제대선취적병례진행측정。결과AMI환자기개단백I、CK-MB、기홍단백적양성솔균고우대조조（P＜0．05），재2～＜6h시간단내삼자적민감도분별위35．7％、64．3％、52．4％，균저우6～12h시간단적48．9％、85．1％、76．6％，결과차이유통계학의의（P＜0．05）。CK-MB용우진단적민감도재량개시간단내분별위：64．3％、85．1％，교기개단백I（35．7％、48．9％）、기홍단백（52．4％、76．6％）고，차이유통계학의의（P＜0．05），이기홍단백민감도교기개단백I고（P＜0．05）。장삼자연합측정시，양성솔고우단독측정시적양성솔，2～6h조양성솔위69．0％，6～12h조양성솔위89．4％。결론재AMI조기，기개단백I、CK-MB、기홍단백단독측정양성솔교저，불능만족림상수요，이채용효체금법심기삼합일진단시제합，대기개단백I、CK-MB、기홍단백진행연합측정능제고AMI적조기진단양성솔，이편위림상제공가고적실험신식，급시채취유효적치료조시，종이강저환자적병사솔。
Objective To explore the early diagnostic value of colloidal gold immune chromatography testing serum troponin I, creatine kinase isoenzyme (CK-MB),myoglobin in different periods among patients with acute myocardial infarction.MethodsEighty-nine patients diagnosed with AMI from January 2011 to December 2012 in Suining central hospital were divided into two groups:2-<6 h group with 42 cases,and 6-12 h group with 47 cases.The control group included seventy non-AMI patients.All the cases were tested serum troponin I,CK-MB and myoglobin by colloidal gold immune chromatography.Results The positive rate of myocardial troponin I,CK-MB,myoglobin in AMI patients were higher than that of the control group(P<0.05).In 2-<6 h group,the sensitivity of the three cardiac markers were 35.7%、64.3%、52.4%,respectively,lower than these of 6-12 h group, 48.9%,85.1% and 76.6%,respectively.There were statistical difference between the two groups(P<0.05).The sensitivity of CK-MB was 64.3% in 2-<6 h group and 85.1% in 6-12 h group,significantly higher than that of troponin I (35.7%,48.9%, respectively)and myoglobin(52.4%,76.6%,respectively).In addition,compared with troponin I,the sensitivity of myoglobin was higher(P<0.05).And all of the difference had statistical significance.The positive rate of combined detection was obviously higher than that of single detection (P<0.05):69.0% in 2-<6 h group and 89.4% in 6-12 h group.Conclusion In early stage of AMI,the low positive rate by detecting a seperated cardiac marker cannot meet the clinical needs,while combined detection of serum troponin I,CK-MB,myoglobin by colloidal gold immune chromatography could develop the positive rate in AMI diagnosing,in order to provide reliable information and reduce the mortality rate.