倪童天, 陈影, 王义辉, 陈敏, 盛慧球, 周伟君, 毛恩强, 陈尔真. 即时检验法替代常规检验法检测心脏标志物的临床探讨[J]. 职业卫生与应急救援, 2019, 37(5): 416-419, 436. DOI: 10.16369/j.oher.issn.1007-1326.2019.05.005
引用本文: 倪童天, 陈影, 王义辉, 陈敏, 盛慧球, 周伟君, 毛恩强, 陈尔真. 即时检验法替代常规检验法检测心脏标志物的临床探讨[J]. 职业卫生与应急救援, 2019, 37(5): 416-419, 436. DOI: 10.16369/j.oher.issn.1007-1326.2019.05.005
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NI Tongtian, CHEN Ying, WANG Yihui, CHEN Min, SHENG Huiqiu, ZHOU Weijun, MAO Enqiang, CHEN Erzhen. Clinical study on POCT method instead of routine test for detecting myocardial markers[J]. Occupational Health and Emergency Rescue, 2019, 37(5): 416-419, 436. DOI: 10.16369/j.oher.issn.1007-1326.2019.05.005
Citation: NI Tongtian, CHEN Ying, WANG Yihui, CHEN Min, SHENG Huiqiu, ZHOU Weijun, MAO Enqiang, CHEN Erzhen. Clinical study on POCT method instead of routine test for detecting myocardial markers[J]. Occupational Health and Emergency Rescue, 2019, 37(5): 416-419, 436. DOI: 10.16369/j.oher.issn.1007-1326.2019.05.005
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即时检验法替代常规检验法检测心脏标志物的临床探讨

Clinical study on POCT method instead of routine test for detecting myocardial markers

    摘要
  • 摘要:
    目的 探讨即时检验法（point-of-care testing，POCT）在实验室替代常规检验法检测急性冠脉综合征（acute coronary syndrome，ACS）患者心脏标志物的可能性。
    方法 将60例拟诊为ACS的患者随机分为POCT组和常规检验组，分别在实验室内使用POCT和常规检验法检测心脏标志物肌红蛋白（Myo）、肌钙蛋白I（cTnI）、肌酸激酶同工酶（CK-MB），记录并比较患者在急诊就诊期间、入院第3天、入院第7天获取心脏标志物检测结果报告的时间、检测值变化趋势，以及住院时间和28 d死亡率。
    结果 ACS患者在急诊就诊时POCT组心脏标志物的检测结果报告获取时间为（61.10 ±27.45）min，常规检验组为（76.50 ±31.25）min，两者差异有统计学意义（P < 0.05）。入院期间第3天两组检验结果报告获取时间分别为（140.67 ±81.50）min和（220.90 ±63.14）min；第7天分别为（151.83 ±65.22）min和（198.63 ±60.39）min；以上差异在两组间比较，差异均有统计学意义（P < 0.05）。两组患者心脏标志物的变化趋势基本相符。两组患者住院时间、住院费用及28 d病死率比较，差异均无统计学意义（P>0.05）。
    结论 同常规检验方法相比，采用POCT法检测ACS患者的心脏标志物，有助于为ACS的早期诊断以及后续治疗争取时间，且在住院费用方面非常接近。故可以考虑引入POCT技术替代常规检验法。

     

    Abstract:
    Objective To investigate whether the POCT technique can replace routine test for detecting myocardial damage markers in patients with acute coronary syndrome (ACS).
    Methods A total of 60 patients with ACS were randomly divided into the POCT group and the routine test group, respectively. The POCT or traditional laboratory testing methods was used for detection of myocardial damage markers, such as myoglobin (Myo), cardiac troponin I (cTnI), creatine kinase isoenzyme (CK-MB). The reporting time of testing results, the changing tendency of testing indicators during the emergency visits, on the third day and the seventh day of admission, days of hospitalization and fatality rate within 28 days were recorded and also compared.
    Results The reporting time of POCT(61.10 ±27.45) min were statistically shorter than that of routine test(76.50 ±31.25)min during emergency visit. In addition, there were also statistically significant difference (P < 0.05) of the reporting time on third days(140.67 ±81.50)min vs. (220.90 ±63.14)min and on seventh days(151.83 ±65.22)min vs. (198.63 ±60.39)min after admission. The changes of myocardial injury markers in the two groups were basically consistent. There was no significant difference in hospitalization time, hospitalization expenses and fatality rate within 28 days between these two groups (P>0.05).
    Conclusion Compared with routine methods, detection of myocardial markers in patients with ACS by POCT can save time for early diagnosis and follow-up treatment of ACS. And POCT is very close in terms of hospitalization expenses. POCT technique may be considered as an alternative to routine test.

     

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