摘要
目的探讨肌酸激酶(CK)、肌酸激酶同功酶(CK-MB)、同型半胱氨酸(HCY)和乳酸脱氢酶(LDH)等心肌酶,联合血清缺血修饰清蛋白(IMA)和超敏肌钙蛋白Ⅰ(TnⅠ-Ultra)等心肌损伤相关蛋白检测在急性心肌梗死(acute myocardial infarction,AMI)早期诊断中的应用。方法选取我院于2014年1月至2017年1月期间收治的AMI患者150例,病发后6h内采集静脉血,检测患者心肌酶谱(CK、CK-MB、HCY和LDH)及IMA和TnⅠ-Ultra等生化指标。同期选取100例非AMI患者血液样本作为对照组。结果 150例AMI患者血清CK、CK-MB、LDH(U/L)和HCY(μmol/L)水平分别为:688.5±68.7、86.4±9.2、364.7±55.2和34.5±9.4。与对照组相比,CK和CK-MB水平明显升高(P<0.01),而LDH和HCY与对照组相比差异无统计学意义(P>0.05),但IMA(65.5±11.7 U/L)和TnⅠ-Ultra(10.6±3.5μg/L)水平均明显升高,差异有统计学意义(P<0.01)。结论 CK、CK-MB、HCY和LDH等心肌酶指标在AMI患者中有较高的阳性率,但某些非AMI类疾病也可能导致以上指标异常升高;IMA和TnⅠ-Ultra等心肌损伤相关蛋白对AMI诊断有较高的特异性。心肌酶联合心肌损伤相关蛋白检测有助于AMI的早期诊断,对降低AMI风险具有重要意义。
Objective To investigate the early diagnostic value of detection of creatine kinase （CK）, creatine kinase isoenzyme （CK-MB）, homocysteine （HCY） and lactate dehydrogenase （LDH） combined with detection of damage associated protein serum ischemia modified albumin （IMA） and Ultrasensitive troponin I （TnI-Ultra） in acute myocardial infarction （AMI）.Methods We collected 150 cases of AMI patients during the period of January 2014 to January 2017 from our hospital, and patients′ venous blood samples were collected at 6 hours.Some biochemical indexes such as myocardial enzymes （CK, CK-MB, HCY and LDH）, IMA and TnI-Ultra were collected.At the same time, 100 cases of non AMI patients were selected as control group.Results The levels of serum CK, CK-MB, LDH （U/L） and HCY （μmol/L） in 150 AMI patients were： 688.5±68.7, 86.4±9.2, 364.7±55.2 and 34.5±9.4.Compared with the control group, CK and CK-MB levels were significantly increased （P〈0.01）, and the lever of LDH and HCY had no significant difference compared with the control group （P〉0.05）.However, the IMA （65.5±11.7 U/L） and TnI-Ultra （0.6±3.5μg/L） levels were significantly increased （P〈0.01）.Conclusion The level of myocardial enzyme CK, CK-MB, HCY and LDH used to evaluate the risk of AMI may have some levels of false positives, so it is helpful for the early diagnosis of AMI to combine with damage associated protein IMA and TnI-Ultra detection, which is significant to reduce the risk of AMI.
作者
冷德文
柳梅
范学朋
胡珺
LENG De- wen LIU Mei FAN Xue- peng HU Jun(Department of Critical Care Medicine, Wuhan First Hospital, Wuhan 430032, China Department of Physical Examination, Wuhan Occupational Disease Control Hospital, Wuhan 430016, China)
出处
《标记免疫分析与临床》
CAS
2017年第9期1033-1035,1067,共4页
Labeled Immunoassays and Clinical Medicine
关键词
心肌酶谱
血清缺血修饰清蛋白
超敏肌钙蛋白I
急性心肌梗死
早期诊断
Myocardial enzyme spectrum
Ischemia modified albumin
Ultrasensitive troponin I
Acute myocardial infarction
Early diagnostic
