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急性心肌梗死(AMI)的诊断基于WH0的标准,包括下列三项中的二项——临床症状、心电图异常和血清中总CK、LDH以及同工酶含量异常。但由于大约25％的AMI病人发病早期没有典型的临床症状,约50％病人心电图无典型的异常表现,若单单依靠心电图改变和临床症状,AMI诊断符合率仅为75％,所以血清学检查成为重要诊断指标,CK-MB成为诊断AMI的“金标准”。由于CK-MB并非心肌专一,在骨骼肌疾病等亦见增高,且诊断窗口期较短,给AMI早期诊断带来一定的困难。随着实验医学的发展,出现了许多新的检测项目,特异性、灵敏度均明显增高,对CK-MB“金标准”提出了挑战,对AMI的早期诊断、病情监测、预后判断、减少并发症的发生等起重要作用。本文就AMI检测的几种血清学标志物作一综述。 1 肌红蛋白(Mb)
The diagnosis of acute myocardial infarction (AMI) is based on the WH0 criteria and includes two of the following three items - clinical symptoms, abnormalities in electrocardiogram, and abnormalities in total CK, LDH, and isozyme levels in the serum. However, about 25% of patients with AMI do not have typical clinical symptoms in the early stage of disease. About 50% of patients have no typical ECG abnormalities. If the diagnosis of AMI is only 75% by relying solely on ECG changes and clinical symptoms, serological examination becomes Important diagnostic indicators, CK-MB diagnosis of AMI as the “gold standard.” Because CK-MB is not cardiomyopathy, it also increases in skeletal muscle diseases, etc., and the diagnosis window is short, which brings some difficulties in the early diagnosis of AMI. With the development of experimental medicine, many new test items have emerged, and the specificity and sensitivity have been significantly raised. This poses a challenge to CK-MB “Gold Standard” and provides early diagnosis, condition monitoring, prognosis judgment and reduction of complications for AMI The occurrence of such play an important role. This article reviews several serological markers of AMI. 1 myoglobin (Mb)