Menéndez Fernández J M, Romero Tarín E, Fernández B, Fernández Coto T, del Busto Prado F, Mayordomo López J, Marín Fernández B
Servicio de Urgencias, Hospital Covadonga, Oviedo.
Med Clin (Barc). 1992 Jul 4;99(6):213-7.
To evaluate the diagnostic power of serum myoglobin (Mgb) by latex agglutination as a marker in the first hours of acute myocardial infarction (AMI).
Two hundred forty-eight serum samples from 53 patients admitted to the Coronary Unit (CU) from the Emergency Department (ED) for suspected AMI were studied. The extractions were carried out upon admission and at 4, 8, 12, 18, 24 and 36 hours after the initiation of symptoms. Myoglobin was analyzed by radioimmunoassay (RIA) and by a semiquantitative method of latex agglutination (Rapitex), in addition to creatine kinase (CK) and MB fraction (CK-MB). Sensitivity (S), specificity (E), positive and negative predictive value (PPV) (NPV) and standard efficacy (SE) of the different markers were measured along with the correlation between RIA and latex methods for Mgb.
For a prevalence of 83%, the latex test provided S = 81%, E = 8%, PPV = 97%, NPV = 50%, ES = 0.85; CK S = 43% (), E = 88%, PPV = 97%, NPV = 24% () and ES = 0.31 () ( = p less than 0.01) and CK-MB S.63% (), E = 100%, PPV = 100%, NPV = 34% () and ES = 0.31 () ( = p less than 0.05). The correlation between latex and RIA in the first 4 hours was r = 0.8243 (p less than 0.0001). On performing the 2 tests separated by 2 in the first 4, latex NPV was 100%.
Mgb - latex is the earliest AMI indicator and has greater diagnostic strength in the first hours than CK and CK-MB. It has a good correlation with Mgb-RIA and is simple and rapid to carry out making it specially useful in Emergency Departments and Coronary Units.
评估乳胶凝集法检测血清肌红蛋白（Mgb）作为急性心肌梗死（AMI）发病最初几小时标志物的诊断效能。
对53例因疑似AMI从急诊科（ED）收入冠心病监护病房（CU）的患者的248份血清样本进行研究。在入院时以及症状出现后4、8、12、18、24和36小时进行样本采集。除肌酸激酶（CK）和MB同工酶（CK-MB）外，采用放射免疫分析法（RIA）和乳胶凝集半定量法（Rapitex）分析肌红蛋白。测定不同标志物的敏感性（S）、特异性（E）、阳性和阴性预测值（PPV）（NPV）以及标准效能（SE），同时测定RIA法和乳胶法检测Mgb的相关性。
在患病率为83%时，乳胶试验的S = 81%，E = 8%，PPV = 97%，NPV = 50%，ES = 0.85；CK的S = 43%（），E = 88%，PPV = 97%，NPV = 24%（），ES = 0.31（）（ = p < 0.01）；CK-MB的S = 63%（），E = 100%，PPV = 100%，NPV = 34%（），ES = 0.31（）（ = p < 0.05）。最初4小时内乳胶法与RIA法的相关性为r = 0.8243（p < 0.0001）。在最初4小时内每隔2小时进行两次检测时，乳胶法的NPV为100%。
Mgb - 乳胶法是最早的AMI指标，在发病最初几小时比CK和CK-MB具有更强的诊断能力。它与Mgb-RIA具有良好的相关性，操作简单快速，特别适用于急诊科和冠心病监护病房。
