CAJ | 학술논문

目的：探讨快速床旁心肌钙蛋白 I（cTnI）、肌红蛋白（MYO）及肌酸激酶同工酶（CK-MB）水平联合测定在急性心肌梗死（AMI）诊断的临床应用价值。方法收集冠状动脉综合征病例74例为患病组，健康体检者40例为健康对照组。不同时间用床旁快速免疫定量法测定 cTnI、MYO、CK-MB 水平，比较诊断 AMI 的敏感性和特异性，确定联合检测和独立检测的最佳时间具有不同的诊断价值。结果 AMI 组发病有症状2～12 h cTnI、MYO、CK-MB 阳性率均显著高于不稳定型心绞痛（UAP）组及健康对照组。差异有统计学意义（P ＜0．01）。在发病有症状后6～12 h 采集标本分析，cTnI、MYO、CK-MB 联合检测诊断 AMI，有较高的敏感性和特异性，在发病有症状后的12～24 h 采集标本联合检测 cTnI、CK-MB 诊断 AMI。可达到最佳敏感性和特异性。在发病有症状后24～72 h 采集标本分析，cTnI 诊断的敏感性和特异性分别是100．0％和100．0％。结论床旁 cTnI、MYO、CK-MB 联合检测能够方便、快速诊断 AMI，不同时间段各项指标的敏感性和特异性有差异，联合测定可以提高对 AMI 的诊断率。
목적：탐토쾌속상방심기개단백 I（cTnI）、기홍단백（MYO）급기산격매동공매（CK-MB）수평연합측정재급성심기경사（AMI）진단적림상응용개치。방법수집관상동맥종합정병례74례위환병조，건강체검자40례위건강대조조。불동시간용상방쾌속면역정량법측정 cTnI、MYO、CK-MB 수평，비교진단 AMI 적민감성화특이성，학정연합검측화독립검측적최가시간구유불동적진단개치。결과 AMI 조발병유증상2～12 h cTnI、MYO、CK-MB 양성솔균현저고우불은정형심교통（UAP）조급건강대조조。차이유통계학의의（P ＜0．01）。재발병유증상후6～12 h 채집표본분석，cTnI、MYO、CK-MB 연합검측진단 AMI，유교고적민감성화특이성，재발병유증상후적12～24 h 채집표본연합검측 cTnI、CK-MB 진단 AMI。가체도최가민감성화특이성。재발병유증상후24～72 h 채집표본분석，cTnI 진단적민감성화특이성분별시100．0％화100．0％。결론상방 cTnI、MYO、CK-MB 연합검측능구방편、쾌속진단 AMI，불동시간단각항지표적민감성화특이성유차이，연합측정가이제고대 AMI 적진단솔。
Objective To investigate the clinical application value of point-of-care combined detection of cTnI,MYO and CK-MB in the patients with acute myocardial infarction (AMI).Methods 74 cases of coronary syndrome were collected as the patients group,including 36 cases of AMI and 38 cases of unstable angina pectoris(UAP),and 40 individuals with healthy physical examina-tion were selected as the control group.The concentrations of cardiac marker cTnI,MYO and CK-MB in blood at different times were detected by using the point-of-care rapid immune quantitative method.Then the sensitivity and specificity for diagnosing AMI were compared for determining the best time of single detection and combined detection.Results The positive rates of cTnI,MYO and CK-MB within onset 2-12 h with the symptoms in the AMI group were higher than those in the control group and the UAP group,the difference had statistical significance (P <0.01).The combined detection of cTnI,MYO and CK-MB within onset 6-12 h with symptoms had the higher sensitivity and higher specificity for diagnosing AMI.The combined detection of cTnI and CK-MB within onset 12-24 h with symptoms could reach the optimal sensitivity and optimal specificity for the diagnosis.The sensitivity and specificity of cTnI within onset 24-72 h with symptoms for diagnosing AMI were 100.0% and 100.0% respectively.Conclu-sion The point-of-care combined detection of cTnI,MYO and CK-MB can conveniently and rapidly diagnose AMI.The sensitivty and specificity of various indexes in different time periods are different.Their combined detection can increase the diagnostic rate for AMI.