四川大学学报（医学版）2009，Vol.40Issue(6)：1082-1085,4.
急性心肌梗死诊断中心肌损伤标志物联合应用的临床价值
Combined Myocardial Injury Markers for Diagnosis of Acute Myocardial Infarction
贾成瑶 1王莉 2毛志刚 3张居龙 3张立4
作者信息
- 1. 四川大学华西医院,实验医学科临床生化室,成都,610041
- 2. 四川大学华西医院,中国循证医学中心
- 3. 四川大学华西医院,住院医师培训部
- 4. 四川大学华西医院,心内科
- 折叠
摘要
Abstract
Objective To compare the diagnostic accuracy of different myocardial injury markers and their combinations in diagnosing acute myocardial infarction (AMI). Methods The myocardial injury markers: AST, CK, CK-MB, LDH, HBDH, cTnl, CK-MB mass were detected in patients with acute chest pain-onset who were hospitalized in Sichuan University West China Hospital from July 2005 to October 2006. The accuracy of those markers in diagnosing AMI were evaluated by their sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio. Student t-test and one-way ANOVA were performed to compare the diagnostic accuracy of the markers. Results cTnl had the highest diagnostic accuracy, with 85% of sensitivity and 92. 5% of specificity (P<0. 05). cTnl in parallel with myocardial enzymes produced the highest combined diagnostic accuracy, with 100% of sensitivity and 37. 29% of specificity (P<0. 05). Myocardial enzymes in sequence with cTnl produced the highest sequential diagnostic accuracy, with 50% of sensitivity and 100% of specificity (P<0. 05). Conclusion cTnl is the best indicator for diagnosis and differential diagnosis of AMI. Myocardiozymogram is poor in sensitivity and specificity, which should be used only in combination with cTnl or CK-MB mass. Parallel testing can increase sensitivity, while sequential testing can improve specificity.关键词
急性心肌梗死/心肌损伤标志物/联合应用Key words
Acute myocardial infarction/Myocardial injure marker/Combination分类
医药卫生引用本文复制引用
贾成瑶,王莉,毛志刚,张居龙,张立..急性心肌梗死诊断中心肌损伤标志物联合应用的临床价值[J].四川大学学报（医学版）,2009,40(6):1082-1085,4.
