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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 effects of creatine kinase (CK), creatine kinase CK (CK-MB), homocysteine (HCY) and lactate dehydrogenase (LDH) ) And hypersensitivity troponin I (TnI-Ultra) in the early diagnosis of acute myocardial infarction (AMI). Methods 150 patients with AMI admitted to our hospital from January 2014 to January 2017 were enrolled in this study. Venous blood was collected within 6 hours after the onset of disease. The myocardial enzymes (CK, CK-MB, HCY and LDH) and IMA Tn Ⅰ-Ultra and other biochemical indicators. In the same period, 100 blood samples from non-AMI patients were selected as the control group. Results The serum CK, CK-MB, LDH (U / L) and HCY (μmol / L) levels in 150 patients with AMI were 688.5 ± 68.7, 86.4 ± 9.2, 364.7 ± 55.2 and 34.5 ± 9.4, respectively. Compared with the control group, CK and CK-MB levels were significantly increased (P <0.01), while there was no significant difference between LDH and HCY groups (P> 0.05), but IMA (65.5 ± 11.7 U / L ) And TnI-Ultra (10.6 ± 3.5μg / L) were significantly increased, the difference was statistically significant (P <0.01). Conclusions CK, CK-MB, HCY and LDH and other myocardial enzymes have a higher positive rate in patients with AMI, but some non-AMI diseases may also lead to the above indexes abnormally increased. The myocardial injury such as IMA and TnI-Ultra are related Protein has a high specificity for the diagnosis of AMI. Myocardial enzymes combined with myocardial injury-related protein detection contribute to the early diagnosis of AMI, to reduce the risk of AMI is of great significance.