血清肌酸激酶同工酶质量联合活性检测在诊断急性心肌梗死的应用价值
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摘要
目的分析在急性心肌梗死(AMI)诊断中,血清肌酸激酶同工酶(CK-MB)质量及活性检测的应用价值。方法以辛集市第一医院2015年1月至2017年3月间120例疑似AMI的患者作为观察对象,根据患者的年龄范围,将患者分为年龄<18岁的未成年组(28例),年龄18～60岁的中青年组(55例),年龄>60岁的老年组(37例)。所有患者均接受CK-MB质量检测、CK-MB活性检测及冠状动脉造影检查,以冠状动脉造影检查结果作为AMI诊断金标准,评估CK-MB质量检测、CK-MB活性检测及CK-MB质量联合活性检测在不同年龄组中的诊断价值。结果在未成年组、中青年组及老年组中,CK-MB质量联合活性的诊断准确性均高于单独CK-MB质量及CK-MB活性检测,而CK-MB质量联合活性的诊断误诊率均低于单独CK-MB质量及CK-MB活性检测。同时,在未成年组、中青年组及老年组中,CK-MB质量联合活性的诊断价值均高于单独CK-MB质量及CK-MB活性检测(P<0.05)。结论在不同年龄段AMI患者的诊断中,CK-MB质量联合活性检测均具有较高的诊断价值,且可降低患者的误诊率。
Objective To analyze the application value of serum creatine kinase isoenzyme(CK-MB) quality test combined activity test in the diagnosis of acute myocardial infarction(AMI). Methods 120 patients with suspected AMI between January 2015 and March 2017 in the First Hospital of Xinji were included in the study. The patients were divided into juveniles' group(age <18 years old, 28 cases), middle-young group(aged 18～60 years, 55 cases), elderly group(age > 60 years, 37 cases) by age. All patients underwent CK-MB quality testing, CK-MB activity testing, and coronary angiography. The results of coronary angiography were used as the gold standard for AMI diagnosis to evaluate the diagnostic value of CK-MB quality test, CK-MB activity test and CK-MB quality test combined activity test in different groups. Results The diagnostic accuracy of CK-MB activity test combined quality test was higher than CK-MB activity test only and CK-MB quality test only in juveniles' group, middleyoung group and elderly group. The misdiagnosis rate of CK-MB activity test combined quality test was lower than CK-MB activity test only and CK-MB quality test only in juveniles' group, young and middle-young group and elderly group. At the same time, the diagnostic value of the CK-MB activity test combined quality test was higher than CK-MB activity test only and CK-MB quality test only in juveniles' group, middle-young group and elderly group(P<0.05). Conclusion In the diagnosis of AMI patients of different ages, CK-MB quality test combined activity test has a higher diagnostic value, and can reduce the rate of misdiagnosis of patients.
Objective To analyze the application value of serum creatine kinase isoenzyme(CK-MB) quality test combined activity test in the diagnosis of acute myocardial infarction(AMI). Methods 120 patients with suspected AMI between January 2015 and March 2017 in the First Hospital of Xinji were included in the study. The patients were divided into juveniles' group(age <18 years old, 28 cases), middle-young group(aged 18～60 years, 55 cases), elderly group(age > 60 years, 37 cases) by age. All patients underwent CK-MB quality testing, CK-MB activity testing, and coronary angiography. The results of coronary angiography were used as the gold standard for AMI diagnosis to evaluate the diagnostic value of CK-MB quality test, CK-MB activity test and CK-MB quality test combined activity test in different groups. Results The diagnostic accuracy of CK-MB activity test combined quality test was higher than CK-MB activity test only and CK-MB quality test only in juveniles' group, middleyoung group and elderly group. The misdiagnosis rate of CK-MB activity test combined quality test was lower than CK-MB activity test only and CK-MB quality test only in juveniles' group, young and middle-young group and elderly group. At the same time, the diagnostic value of the CK-MB activity test combined quality test was higher than CK-MB activity test only and CK-MB quality test only in juveniles' group, middle-young group and elderly group(P<0.05). Conclusion In the diagnosis of AMI patients of different ages, CK-MB quality test combined activity test has a higher diagnostic value, and can reduce the rate of misdiagnosis of patients.
引文
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[10]梁海琦.肌钙蛋白I和肌酸激酶同工酶定量检测对急性心肌梗死的诊断价值[J].临床合理用药杂志,2017,10(30):122-3.
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[15]钟斌才.hs-CRP、CK-MB mass和cTnI联合检测在小儿病毒性心肌炎诊断中的价值[J].海南医学院学报,2014,20(7):980-2,987.
[16]李文强,余宏斌,朱洪斌,等.急性心肌梗死患者心肌损伤标志物检测在早期诊断中的应用价值分析[J].中国循证心血管医学杂志,2017,9(11):1349-1.
[17]曾令恒,赵艳华,何思杰,等.cTnI、Mb、CK-MB联合检测在急性心肌梗死诊断中的临床价值[J].中国实用医药,2017,12(12):65-6.
[18]顾永林,郭俊林,蒋灵霓,等.急性ST段抬高性心肌梗死患者再灌注治疗后心肌损伤指标动态变化的价值[J].中国循证心血管医学杂志,2016,8(9)1119-21.
[19]曾桂芬,徐宝灵,刘行超,等.血清心肌酶和超敏C反应蛋白联合检测在急性冠脉综合征诊断中的应用价值[J].中国老年学,2017,37(5):1106-8.
[20]张龙,秦宗和,徐伟.血清miR-1对急性心肌梗死的诊断价值研究[J].国际检验医学杂志,2018(6):693-5.
[2]刘杰,陈挺,余云华,等.上海市杨浦区2007~2014年急性心肌梗死空间数据探索性分析[J].中国循证心血管医学杂志,2016,8(4):464-7.
[3]王玉花,陈绵聪,陈梁,等.急性心肌梗死患者早期溶栓与非早期溶栓的对照研究[J].血栓与止血学,2016,22(5):554-5.
[4]代娜,于玺.易化经皮冠状动脉介入治疗早期阻抑急性心肌梗死左室重构的效应[J].中国老年学杂志,2016,36(8):1857-8.
[5]柴琳,杨汝文,李云芬,等.肌酸激酶同工酶CKMB质量和活性的比较[J].医药前沿,2017,7(3):340-1.
[6]叶子,黄应雄,郑梓煜,等.床边敏感性肌钙蛋白Ⅰ对急性心肌梗死的早期诊断价值[J].中华急诊医学杂志,2016,25(6):784-91.
[7]王肖引.心肌标志物检测对急性心肌梗死的快速诊断价值[J].河南医学研究,2017(19):3593-4.
[8]朱光明.急性心肌梗死患者血清B型钠尿肽、肌钙蛋白Ⅰ和心肌型肌酸激酶同工酶水平及其临床意义[J].现代实用医学,2017,29(3):315-6.
[9]韩宇东.急性心肌梗死患者血清Hcy、UA、LDL-C、cTnI、Myo、CK-MB联合检测的临床价值分析[J].医学理论与实践,2017,30(10):1507-8.
[10]梁海琦.肌钙蛋白I和肌酸激酶同工酶定量检测对急性心肌梗死的诊断价值[J].临床合理用药杂志,2017,10(30):122-3.
[11]容文明.急性心肌梗死患者血清GDF-15与CK-MB、cTnI、Mb之间的关系[J].中国循证心血管医学杂志,2016,8(3)344-6.
[12]胡娟娟,郝晓柯,周铁城,等.心肌损伤标志物联合检测在急性心肌梗死早期诊断中的应用价值[J].国际检验医学杂志,2017,38(11):1545-7.
[13]王子宽,杨竞肖,白宝宝,等.急性心肌梗死患者血清hs-CRP及CK-MB水平与患者Gensini评分相关性研究[J].陕西医学杂志,2017,46(1):121-2.
[14]张婷,龚跃云,朱力,等.感染性疾病患儿血清CK-MB活性与质量和cTnⅠ水平比较及其临床价值[J].中华临床实验室管理电子杂志,2015,3(2):113-7.
[15]钟斌才.hs-CRP、CK-MB mass和cTnI联合检测在小儿病毒性心肌炎诊断中的价值[J].海南医学院学报,2014,20(7):980-2,987.
[16]李文强,余宏斌,朱洪斌,等.急性心肌梗死患者心肌损伤标志物检测在早期诊断中的应用价值分析[J].中国循证心血管医学杂志,2017,9(11):1349-1.
[17]曾令恒,赵艳华,何思杰,等.cTnI、Mb、CK-MB联合检测在急性心肌梗死诊断中的临床价值[J].中国实用医药,2017,12(12):65-6.
[18]顾永林,郭俊林,蒋灵霓,等.急性ST段抬高性心肌梗死患者再灌注治疗后心肌损伤指标动态变化的价值[J].中国循证心血管医学杂志,2016,8(9)1119-21.
[19]曾桂芬,徐宝灵,刘行超,等.血清心肌酶和超敏C反应蛋白联合检测在急性冠脉综合征诊断中的应用价值[J].中国老年学,2017,37(5):1106-8.
[20]张龙,秦宗和,徐伟.血清miR-1对急性心肌梗死的诊断价值研究[J].国际检验医学杂志,2018(6):693-5.
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