许汉进 陈美英

    广东省水电医院急诊科，广东广州 511340

    肌钙蛋白I以及D-二聚体在诊断胸痛患者中的应用分析

    许汉进 陈美英

    广东省水电医院急诊科，广东广州 511340

    目的研究肌钙蛋白I与D-二聚体在诊断胸痛患者中的临床意义。方法选取我院2013年2月～2017年2月收治的胸痛患者800例为研究对象，将患者根据致病因素分为急性心肌梗死组、主动脉夹层组和肺栓塞组。对三组患者的D-二聚体及肌钙蛋白I含量进行检测，对比各组患者的发病时间与D-二聚体水平、肌钙蛋白I水平的关系；对比胸痛致病类型与D-二聚体水平、肌钙蛋白I水平及两者联合检测之间的敏感性和特异性。两组患者的一般临床资料比较差异无统计学意义(P>0.05)。结果急性心肌梗死组在发病16h后D-二聚体呈阳性，发病4h后肌钙蛋白I呈阳性；主动脉夹层组及肺栓塞组在发病4h后D-二聚体呈阳性，发病16h后肌钙蛋白I呈阳性；各组数据比较差异具有统计学意义(P<0.05)。三组患者采用D-二聚体和肌钙蛋白I联合检测与仅采用D-二聚体或肌钙蛋白I进行检测相比敏感性和特异性均显著升高，各项指标组间比较差异有统计学意义(P<0.05)。结论D-二聚体和肌钙蛋白I两项指标联合检测在临床上可以显著提高胸痛的鉴别诊断的准确率。

    肌钙蛋白I；D-二聚体；胸痛；诊断

    R54

    A

    2095-0616(2018)01-198-03

    Application of troponin I and D-dimer in diagnosis of chest pain

    XU Hanjin CHEN Meiying

    Department of Emergency,Guangdong Provincial Water and Electricity Hospital,Guangzhou 511340,China

    ObjectiveTo study the clinical significance of troponin I and D-dimer in the diagnosis of chest pain.MethodsEight hundred patients with chest pain admitted in our hospital from February 2013 to February 2017 were selected as the research subjects.Patients were divided into acute myocardial infarction group,aortic dissection group and pulmonary embolism group according to the pathogenic factors.The levels of D-dimer and troponin I were detected in the three groups,and the relationship between the onset time and the levels of D-dimer and troponin I was compared.the sensitivity and specificity between the type of chest pain and D-dimer level,troponin I level and their combined detectionwere compared.There was no significant difference in the general clinical data between the two groups (P>0.05).ResultsIn acute myocardial infarction group,D-dimer was positive 16h after onset and troponin I was positive 4h after onset.The D-dimer was positive in aortic dissection group and pulmonary embolism group after 4 hours of onset,and troponin I was positive after 16h of onset.There was significant difference between the two groups(P<0.05).The sensitivity and specificity of combined detection of D-dimer and troponin I in the three groups were significantly higher than those of D-dimer or troponin I alone.There were significant differences among the index groups (P<0.05).ConclusionThe combined detection of D-dimer and troponin I can significantly improve the accuracy of differential diagnosis of chest pain. ......