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目的评价通过血清心肌肌钙蛋白I(cTnI)时间-浓度曲线计算的心肌梗死体积(MIS)在急性心肌梗死中的价值。方法选择2002年9月至2003年9月的31例急性ST段抬高型心肌梗死(ASTEMI)患者为研究对象。采用酶联免疫分析法检测血清cTnI水平3次以上,利用血清cTnI的时间-浓度曲线估测MIS。运用统计学方法分析MIS与肌酸磷酸激酶(CK)同工酶MB(CK-MB)峰值、LVEF的关系。结果(1)MIS与CK-MB峰值具相关性,r值为0.73(P<0.05)。(2)MIS≥40cTnI-g组LVEF值明显小于MIS<40 cTnI-g组(P<0.05)。结论(1)cTnI具有很高的心肌特异性,可用于AMI的诊断和排除诊断。(2)利用cTnI估测出ASTEMI患者的MIS,MIS与CK-MB峰值密切相关。(3)MIS与ASTEMI患者的心功能相关。
Objective To evaluate the value of myocardial infarct volume (MIS) calculated by the serum cardiac troponin I (cTnI) time-concentration curve in acute myocardial infarction. Methods Thirty-one patients with acute ST-segment elevation myocardial infarction (ASTEMI) from September 2002 to September 2003 were selected as the study subjects. Serum cTnI level was detected by enzyme-linked immunosorbent assay more than 3 times, MIS was estimated by time-concentration curve of serum cTnI. The relationship between MIS and creatine phosphokinase (CK) isoenzyme MB (CK-MB) peak and LVEF was analyzed by statistical methods. Results (1) The correlation between MIS and CK-MB peak was significant (r = 0.73, P <0.05). (2) LVEF of MIS≥40cTnI-g group was significantly lower than that of MIS <40 cTnI-g group (P <0.05). Conclusions (1) cTnI has high myocardial specificity and can be used for the diagnosis and diagnosis of AMI. (2) The cTnI was used to estimate the MIS, MIS and CK-MB peak value of ASTEMI patients. (3) MIS is associated with cardiac function in patients with ASTEMI.