血清心脏肌球蛋白结合蛋白C检测在急性心肌梗死患者诊断中的作用
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(1.连云港市第二人民医院心血管内科,江苏省连云港市 222000;2.苏州大学附属第一医院心血管内科,江苏省苏州市 215006)

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顾遵才,硕士,主治医师,研究方向为心血管疾病诊疗,E-mail为guzuncai2075@126.com。

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Effects of Serum Cardiac Myosin Binding Protein-C Measurement in the Diagnosis of Patients with Acute Myocardial Infarction
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1.Department of Cardiology, the Second People's Hospital of Lianyungang, Lianyungang, Jiangsu 222000, China;2.Department of Cardiology, the First Affiliated Hospital, Soochow University, Suzhou, Jiangsu 215006, China)

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    摘要:

    目的 探讨血清心脏肌球蛋白结合蛋白C(cMyBP-C)在急性心肌梗死(AMI)患者诊断中的价值。方法 选择2014年3月至2015年11月心血管内科收治的AMI患者62例作为病例组,选取正常体检者60例作为对照组。采用双抗体夹心酶联免疫吸附试验(ELISA)法检测血清cMyBP-C浓度。比较AMI组与对照组间cMyBP-C、肌钙蛋白Ⅰ(cTnⅠ)、肌酸激酶同工酶(CK-MB)和肌红蛋白(Myo)浓度的差异,分析AMI组cMyBP-C与cTnⅠ、CK-MB和Myo的相关性,同时分析发病时间小于4 h的AMI患者入院时血清cMyBP-C和cTnⅠ浓度与对照组的差异,比较急诊经皮冠状动脉介入(PCI)术后12 h与入院时血清cMyBP-C和cTnⅠ的差异。结果 AMI组患者血清cMyBP-C、cTnⅠ、CK-MB和Myo浓度较对照组均明显升高(P<0.05)。相关性分析显示,AMI组患者cMyBP-C浓度与cTnⅠ、CK-MB和Myo浓度均存在正相关(分别为r=0.876、P<0.05;r=0.632、P<0.05和r=0.903、P<0.05)。发病时间小于4 h的AMI患者入院时血清cMyBP-C浓度较对照组明显升高(P<0.05),而血清cTnⅠ浓度与对照组比较差异无统计学意义(P>0.05)。行急诊PCI术后12 h血清cMyBP-C浓度较入院时明显下降,而cTnⅠ浓度较入院时明显升高(P<0.05)。结论 AMI患者入院时血清cMyBP-C、cTnⅠ、CK-MB和Myo浓度较对照组均显著升高且cMyBP-C浓度与cTnⅠ、CK-MB和Myo浓度均存在正相关;cMyBP-C在发病4 h内即开始升高,提示cMyBP-C可以作为诊断AMI的早期生化标志物。AMI患者行急诊PCI术后12 h血清cMyBP-C浓度较入院时明显下降,表明cMyBP-C可以作为评估PCI术效果的早期指标。

    Abstract:

    Aim To investigate the value of serum cardiac myosin binding protein-C (cMyBP-C) in the diagnosis of patients with acute myocardial infarction(AMI). Methods Sixty-two patients with AMI were selected as case group in the department of cardiology from March 2014 to November 2015, and sixty persons of normal physical examination were selected as control group. Enzyme-linked immunosorbent assay (ELISA) method was used for determining the concentrations of serum cMyBP-C. The concentration differences of cMyBP-C, cardiac troponin I(cTnⅠ), creatine kinase(CK-MB) and myoglobin(Myo) between AMI group and control group were compared. Correlations between cMyBP-C and cTnⅠ, CK-MB, Myo were analysed in AMI group. The concentration differences of serum cMyBP-C and cTnⅠ were also compared between the control group and AMI patients with the onset time of less than 4 h. The concentration differences of serum cMyBP-C and cTnⅠ were compared between 12 h after PCI and admission. Results In AMI group, the concentrations of serum cMyBP-C, cTnⅠ, CK-MB and Myo were higher than those of control group(P<0.05). Correlation analysis showed that the level of cMyBP-C had positive correlation with those of cTnⅠ,CK-MB and Myo in AMI group(r=0.876, P<0.05; r=0.632, P<0.05 and r=0.903, P<0.05 respectively). For AMI patients with the onset time of less than 4 h, the level of serum cMyBP-C was higher than that of the control group(P<0.05), but there was not significant difference when comparing the level of serum cTnⅠ and that of the control group(P>0.05). After 12 h of emergency PCI, the level of cMyBP-C was lower than that on admission, but the level of cTnⅠ was higher than that on admission (P<0.05). Conclusions The concentrations of serum cMyBP-C, cTnⅠ, CK-MB and Myo in AMI patients were significantly higher than those of control group on admission and the concentration of serum cMyBP-C had positive correlation with those of cTnⅠ, CK-MB and Myo. cMyBP-C started to rise in 4 h. These suggest that cMyBP-C can be used as early biochemical marker in the diagnosis of AMI. The level of serum cMyBP-C decreased obviously after 12 h undergoing emergency PCI in AMI patients. This suggests that cMyBP-C can be used as an early indicator for evaluating the effect of PCI.

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顾遵才,李勋,王正忠,赵思源,曹荣元,孙黎明.血清心脏肌球蛋白结合蛋白C检测在急性心肌梗死患者诊断中的作用[J].中国动脉硬化杂志,2016,24(9):954~958.

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  • 收稿日期:2015-12-21
  • 最后修改日期:2016-04-04
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  • 在线发布日期: 2016-10-13