摘要
目的比较四种心血管疾病hsTnT、CK-MB、AST、LDH水平的区别,统计分析四种心血管疾病hsTnT含量分别<14ng/L、14～30ng/L、30～100ng/和>100ng/L四种浓度范围的患者所占的百分比。方法所有需排除急性心肌梗死的病例均于发病后4h和6～9h两个时间点抽血检查hsTnT、CK-MB、AST、LDH;hsTnT用Roche公司生产的Elecsys2010电化学发光分析仪检测,CK-MB、AST、LDH用RocheModulorP800生化仪检测。结果 hsTnT均值高低排列依次是急性心肌梗死、冠状动脉粥样硬化、不稳定型心绞痛、高血压,其中急性心肌梗死患者hsTnT均值明显高于其他三组疾病。CK-MB的比较,均值高低排列依次是心肌梗死、冠状动脉粥样硬化、不稳定型心绞痛、高血压。CK-MB在心肌梗死组中的均值明显高于其他三组疾病(P<0.05),而AST、LDH在心肌梗死组中的均值与其他三组均值比较升高不明显。急性心肌梗死hsTnT含量在<14ng/L浓度区间的比例为0,在>100ng/L区间的比例为95.8%;冠状动脉粥样硬化组除14～30ng/L区间比例稍少外,其余3个区间的比例相差不明显;不稳定型心绞痛组以<14ng/L和14～30ng/L两个区间比例较大,>100ng/L区间所占比例很少;高血压组大部分在<14ng/L区间,>100ng/L区间很少。结论急性心肌梗死患者hsTnT水平明显高于其他三种心血管疾病(P<0.05);三种酶中CK-MB对心肌梗死诊断特异性明显优于AST、LDH。四种心血管疾病均存在心肌损伤的可能(无论以30ng/L或100ng/L为判断点)。如以hsTnT>100ng/L为心肌梗死判断点,敏感度为95.8%,特异性为68.2%;以hsTnT判断心肌梗死,hsTnT多时间点的动态观察并结合心肌缺血的表现(症状、心电图或影像学结果),更有利于鉴别心肌梗死和其他心血管疾病。
Objective To compare the level of hsTnT,CK-MB,AST,LDH in the four cardiovascular diseases.Counting and analyzing the percentage of patients that the level of hsTnT at four concentration range in four cardiovascular diseases.Methods All the cases that need to excluded acute myocardial infarction were drown off blood to test hsTnT,CK-MB,AST,LDH at 4 hours and 6-9 hours after onset.hsTnT was tested on roche electrochemiluminescence analyzer.CK-MB,AST,LDH was tested on roche modular P 800 biochemical analyzer.Results Low order of hsTnT average level was AMI,coronary atherosclerosis,unstable angina,the average level of AMI was significantly higher than the other three groups（P0.05）.To compare the average level of CK-MB,low order was AMI coronary atherosclerosis,unstable angina,hypertension.CK-MB average level of AMI was significantly higher than the other three groups（P0.05）.Average level of AST,LDH in AMI was not significantly higher than the other three groups.Proportion of AMI that hsTnT level14 ng/L was 0,proportion of AMI that hsTnT level100 ng/L area was 95.8%.Coronary atherosclerosis：in addition to the proportion of slightly less outer 14-30 ng/L,proportion were not significant difference between the other three areas.Unstable angina：there was a larger proportion14 ng/L and 14-30 ng/L areas and a smaller proportion100 ng/L area.Hypertension：most cases 14 ng/L area,little cases100 ng/L area.Conclusion Average level of AMI was significantly higher than the other three groups（P0.05）.Specificity of diagnose AMI,CK-MB was better than AST,LDH.Four cardiovascular diseases have the possibility of myocardial injury（Whether 30 ng/L or 100 ng/L was the point of determine）.If hsTnT100 ng/L was the point of determine to diagnose AMI.Sensitivity 95.8%,specificity 68.2%.Adopt hsTnT to determine AMI,dynamic observation of multiple time points with the performance of myocardial ischemia（Symptoms,ECG or imaging results） was more conducive to identify AMI and other cardiovascular diseases.
出处
《中外医学研究》
2011年第29期5-7,共3页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
急性心肌梗死
心血管疾病
高敏感肌钙蛋白T
Acute myocardial infarction
Cardiovascular diseases
High-sensitivity troponin T
