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目的探讨心脏彩超联合心肌损伤标志物检测在急性心肌梗死患者中的临床运用价值。方法选择2014年8月-2016年5月在本院拟诊急性心肌梗死80例患者作为研究对象,并以同期40例胸痛疑似急性心肌梗死的患者为对照组,均采用超声心动图检查和血清心型脂肪酸结合蛋白(h-FABP)和心肌肌钙蛋白I(c Tn I)检测。结果急性心肌梗死组患者0 h~2 h h-FABP明显升高,而c Tn I处于正常高值,2 h~12 h和12 h~24 h的c Tn I和h-FABP水平均明显高于对照组各时间段,差异有统计学意义(P<0.05);h-FABP、c Tn I、心脏彩超对心肌梗死的诊断符合率分别为90.0%、85.0%、87.5%,联合诊断符合率为100.0%;以0 h~2 h心肌损伤指标水平及心脏彩超结果为标准,对心肌梗死进行诊断h-FABP+c Tn I+心脏彩超诊断的敏感性、特异性、阳性预测值、阴性预测值分别为87.6%、98.4%、87.5%和100.0%,高于单用h-FABP和c Tn I及心脏彩超进行诊断的患者。结论 h-FABP、c Tn I联合心脏彩超诊断心肌梗死,有助于减少急性心肌梗死的漏诊。
Objective To investigate the clinical value of cardiac echocardiography combined with myocardial injury markers in patients with acute myocardial infarction. Methods Eighty patients with acute myocardial infarction (MI) in our hospital from August 2014 to May 2016 were selected as the study subjects. Forty patients with suspected chest pain were enrolled in the study. Echocardiography and serum Cardiac fatty acid binding protein (h-FABP) and cardiac troponin I (cTnI) detection. Results The level of cTn I and h-FABP in patients with acute myocardial infarction was significantly higher than that in patients with acute myocardial infarction, while the level of cTn I was high at 2h-12h and 12h-24h The coincidence rates of h-FABP, cTn I and echocardiography in myocardial infarction were 90.0%, 85.0% and 87.5% in the control group at different time points, and the coincidence rate of combined diagnosis (100.0%). The sensitivity, specificity, positive predictive value and negative predictive value of h-FABP + c Tn I + echocardiography in diagnosis of myocardial infarction were determined by the level of myocardial injury indicators at 0 h ~ Were 87.6%, 98.4%, 87.5% and 100.0% respectively, higher than those diagnosed by h-FABP, cTn I and echocardiography alone. Conclusions The combination of h-FABP and cTn I in the diagnosis of myocardial infarction can reduce the missed diagnosis of acute myocardial infarction.