CK-MBmass, hs-cTnT及CK-MB与急性心肌梗死的相关性及其联合诊断价值

摘要 目的：研究肌酸激酶同工酶质量（CK-MBmass)、肌酸激酶同工酶（CK-MB）和高敏心肌肌钙蛋白T（hs-cTnT）在急性心肌梗死患者（AMI）血清中的含量，并探讨三者联合对AMIDE诊断价值。方法：选择2018年1月到2021年10月我院收治的AMI患者90例作为研究组，并选择同期在我院体检健康志愿者40例作为对照组，比较两组AMI患者血清CK-MBmass，hs-cTnT和CK-MB。根据Killp分级法将不同心力衰竭将AMI患者分为II、III和IV级，并根据心肌梗死范围将AMI患者分为轻度、中度和重度心肌梗死组。比较不同AMI患者血清CK-MBmass，hs-cTnT和CK-MB。通过受试者工作曲线计算血清CK-MBmass，hs-cTnT和CK-MB联合诊断AMI的阳性预测值、阴性预测值、敏感度和特异度。结果：（1）AMI患者血清CK-MBmass，hs-cTnT和CK-MB均显著高于健康志愿者（P<0.05）；（2）AMI患者血清CK-MBmass，hs-cTnT和CK-MB随Killp分级或心肌梗死范围升高而升高（P<0.05）；（3）AMI患者血清CK-MBmass，hs-cTnT，CK-MB与急性心肌梗死患者左室射血分数（LVEF）呈负相关（P<0.05），与左室舒张末期容积（LVEDd）和梗死范围呈正相关（P<0.05）；（4）血清CK-MBmass，hs-cTnT和CK-MB联合检测急性心肌梗死的阳性预测值、阴性预测值、敏感度和特异度均高于单独诊断。结论：血清CK-MBmass，hs-cTnT和CK-MB在AMI患者含量升高，并且与患者心功能和心肌梗死范围有关，适用于AMI的联合诊断。

Correlation of CK-MBmass, hs-cTnT and CK-MB with Acute Myocardial Infarction and Their Combined Diagnostic Value

ABSTRACT Objective: To study the content of creatine kinase isoenzyme (CK-MBmass), creatine kinase isoenzyme (CK-MB) and high-sensitivity cardiac troponin T (hs-cTnT) in the serum of patients with acute myocardial infarction (AMI), and to explore the diagnostic value of the combination of the three in AMI patients. Methods: We selected 90 AMI patients admitted to our hospital from January 2018 to October 2021 as the study group, and selected 40 healthy volunteers in our hospital for physical examination during the same period as the control group, and compared the two groups of AMI patients with serum CK-MBmass, hs- cTnT and CK-MB. According to the Killp classification method, AMI patients with different heart failures are divided into grades II, III and IV, and AMI patients are divided into mild, moderate and severe myocardial infarction groups according to the scope of myocardial infarction. Compare serum CK-MBmass, hs-cTnT and CK-MB in different AMI patients. The positive predictive value, negative predictive value, sensitivity and specificity of the combined diagnosis of AMI in serum CK-MBmass, hs-cTnT and CK-MB were calculated by receiver operating curve. Results: (1) Serum CK-MBmass, hs-cTnT and CK-MB in AMI patients were higher than healthy volunteers(P<0.05); (2) Serum CK-MBmass, hs-cTnT and CK-MB in AMI patients were graded with Killp Or the range of myocardial infarction increased (P<0.05); (3) Serum CK-MBmass, hs-cTnT, CK-MB in patients with AMI were negatively correlated with LVEF in patients with acute myocardial infarction (P<0.05), positively correlated with LVEDd and infarct size (P<0.05); (4) Serum CK-MBmass, hs-cTnT and CK-MB combined detection of the positive predictive value, negative predictive value, sensitivity and specificity of acute myocardial infarction Both are higher than the diagnosis alone. Conclusion: Serum CK-MBmass, hs-cTnT and CK-MB levels increase in patients with AMI, and are related to the patient''s heart function and the extent of myocardial infarction, and are suitable for combined diagnosis of AMI.