急性心肌梗死诊断病例中各种心脏指标的相关性

Nagsen P Kamble, G. Chavan
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摘要

导读:心脏的缺血性损伤及其损伤程度与缺血时间长短直接相关。因为在尸检过程中对心肌梗死的死后诊断是一个挑战,特别是在非常微小的心肌梗死的情况下。生化指标是评估急性冠状动脉综合征的一个非常有用的工具。这些是总肌酸酐激酶,MB亚型和肌红蛋白,以及肌钙蛋白I(cTnI)和心肌肌钙蛋白T (cTnT)。本研究的目的是研究急性心肌梗死诊断病例中CPK-MB、LDH、Trop-I等心脏标志物的状况。材料与方法:本前瞻性研究选取2017年4月至2018年7月尸检中心附属三级政府医院35例猝死患者,通过各种生化指标的评估,探讨猝死的潜在病理。结果:35例患者中,29例患者CPK-MB水平升高。仅4例患者LDH升高。33例肌钙蛋白- 1水平升高。在所有的酶中,与其他两种相比,94%的病例肌钙蛋白- 1水平升高。结果显示,CPK-MB、LDH和Trop I的敏感性和特异性分别为84%和30%、72%和20%、92%和74%。结论:对于心肌梗死的诊断,连续测量cTnI是很重要的,因为当病例在症状出现后早期出现时,第一次测量可能仍为阴性。©2020由创新出版社出版。这是一篇基于CC BY-NC许可的开放获取文章(https://creativecommons.org/licenses/by-nc/4.0/)
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Correlation of various cardiac markers in diagnosed case of acute MI
Introduction: The ischemic injury to the heart and its extent of damage is directly associate with the length of ischemia. For the post mortem diagnosis of MI during an autopsy poses a challenge, particularly in cases of very minute myocardial infract. Biochemical markers provide a very useful tool for the assessment of acute coronary syndrome. These are total creatinine kinase, the MB isoforms and myoglobin,as well as the troponin I(cTnI) and cardiac troponin T (cTnT). The aim of the present study was to study status of cardiac markers like CPK-MB, LDH, Trop-I in diagnosed case of acute MI. Material and Methods: In this prospective study, 35 cases of sudden death that were studied at tertiary care government hospital attached to post-mortem centre during the period from April 2017 to July2018 for the underlying pathology for the sudden death by the assessment of various biochemical markers. Results: It was observed that out of 35 cases, CPK-MB levels were elevated in 29 cases. LDH levels were raised only in 4 cases. Troponin-I levels were raised in 33 cases. Of all the enzymes Troponin-I levels were raised in 94% cases as compared to the other two. It was observed that the sensitivity and specific for CPK-MB, LDH and Trop I were 84% and 30%, 72% and 20 %, 92% and 74% respectively. Conclusion: It was concluded that for the diagnosis of myocardial infarction it is important to perform serial measurement of cTnI because the first measurement may still be negative when the case presents early after the onset of symptoms. © 2020 Published by Innovative Publication. This is an open access article under the CC BY-NC license (https://creativecommons.org/licenses/by-nc/4.0/)
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