摘要
目的 探讨心电图联合血清心肌肌钙蛋白Ⅰ （cTnⅠ）水平检测对急性心肌梗死（AMI）早期的诊断价值.方法 选取AMI患者41例设为研究组,另选取同期健康体检者41例设为对照组,两组均接受心电图检查及血清cTnⅠ水平检测.统计两组入院后不同时间（入院后2、4、6h）血清cTnⅠ水平、心电图,比较两组血清cTnⅠ单独检测及联合检测对AMI的诊断价值.结果 入院后2、4、6h,研究组血清cTnI水平均高于对照组,差异有统计学意义（P＜0.05）;经心电图检查检出AMI患者30例,健康体检者36例;经血清cTnⅠ检测检出AMI患者31例,健康体检者36例;联合诊断检出AMI患者39例,健康体检者38例.联合诊断的敏感度[95.12％ （39/41）]、准确度[93.90％ （77/82）]、阴性预测值[95.00％ （38/40）]均高于心电图检测[73.17％（30/41）、80.49％（66/82）、76.60％ （36/47）]及血清cTnI检测[75.61％ （31/41）、81.71％ （67/82）、78.26％（36/46）],差异均有统计学意义（P均＜0.05）;联合诊断特异性[92.68％（38/41）]、阳性预测值[92.86％（39/42）]均高于心电图[87.80％（36/41）、85.71％ （30/35）]及血清cTnⅠ[87.80％ （36/41）、86.11％ （31/36）],但差异未见统计学意义（P＞0.05）.结论 急性心肌梗死患者血清cTnⅠ水平异常增高,联合心电图检查及血清cTnⅠ水平检测对急性心肌梗死进行诊断可有效提高诊断敏感度及准确度,减少漏诊及误诊,为临床早期制定有效治疗方案提供一定参考依据.
Objective To investigate the value of electrocardiogram （ECG） combined with detection of serum cardiac troponin Ⅰ （cTnⅠ） level in the early diagnosis of acute myocardial infarction （AMI）.Methods Fourty-one patients with AMI were selected as study group,and 41 normal people who received physical examination in the same period were selected as control group.The two groups both experienced ECG and detection of serum cTnⅠ level.The level of serum cTnⅠ and ECG were recorded at different time points （2,4,6 h after admission）,the value of serum cTnⅠ single detection and combination method in the diagnosis of AMI were compared between the two groups.Results The serum cTnⅠ level in the study group was higher than that in the control group at 2,4 and 6 h after admission （P 〈0.05）.ECG found that there were 30 patients with AMI and 36 healthy subjects;cTnⅠ detection shown that there were 31 patients with AMI and 36 healthy subjects;39 AMI patients and 38 healthy subjects were found by ECG combined with serum cTnⅠ detection.The sensitivity of the combined method was 95.12% （39/41）,the accuracy was 93.90% （77/82）,the negative predictive value was 95.00%（38/40）,which were higher than those of ECG [73.17% （30/41）,80.49% （66/82）,76.60%（36/47）] and those of serum cTnⅠ detection [75.61% （31/41）,81.71% （67/82）,78.26%（36/46）],the differences were statistically significant （all P 〈 0.05）.The specificity of combined method was 92.68% （38/41）,the positive predictive value was 92.86% （39/42）,which were higher than those of ECG [87.80% （36/41）,85.71% （30/35）] and serum cTnⅠ [87.80% （36/41）,86.11% （31/36）],but the difference was not statistically significant （P 〉 0.05）.Conclusions The level of serum cTnⅠ in patients with AMI increases abnormally.Combined method of ECG and detection of serum cTnⅠ level can effectively improve the diagnostic sensitivity and accuracy for acute myocardial infarction,which can reduce the misdiagnosis and missed diagnosis,and provide a reference for the clinical early development of effective treatment programs.
作者
马宁
Ma Ning(Depatment of Heart Room, Shengli Oilfield Central Hospital, Dongying, 257000, Chin)
出处
《中国实用医刊》
2018年第3期43-46,共4页
Chinese Journal of Practical Medicine
关键词
心电图
心肌肌钙蛋白Ⅰ
急性心肌梗死
早期诊断价值
Electrocardiogram
Cardiac troponin Ⅰ
Acute myocardial infarction
Early diagnostic value
作者简介
通信作者：马宁，Email：1451605322@qq．com
