文章摘要
范公忍 李俊峡 姚璐 康蒙 曹建彪.血清标志物联合检测在急性冠状动脉综合征诊断中的应用[J].,2014,14(28):5532-5535
血清标志物联合检测在急性冠状动脉综合征诊断中的应用
Application of the Combined Detection of the SerumMarkersin Acute Coronary Syndrome
  
DOI:
中文关键词: 急性冠脉综合征  心肌肌钙蛋白Ⅰ  肌酸激酶同工酶  肌红蛋白  beta型钠尿肽
英文关键词: Acute coronary syndrome  Cardiac troponin  Creatine kinase isoenzyme-MB  Myoglobin  beta-type natriuretic peptide
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作者单位
范公忍 李俊峡 姚璐 康蒙 曹建彪 北京军区总医院:1 全军肝病治疗中心实验室2 心血管内科3 检验科 
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中文摘要:
      目的:探讨血清cTnⅠ、CK-MB、MYO及BNP 联合检测在急性冠状动脉综合征诊断中的临床价值。方法:选择临床及冠状 动脉造影明确诊断的ACS 患者76 例,稳定性心绞痛患者32 例,同期选择35 例健康体检者作实验对照组;应用免疫化学发光法分别检测患者血清中cTnⅠ、CK-MB、MYO及BNP 水平,采用受试者工作特征曲线(ROC)评价各指标的敏感度、特异度,并分析4 项指标联合检测的诊断价值。结果:ACS 组血清cTnⅠ、CK-MB、MYO 及BNP 水平分别为(9.27± 7.25)ug/L、(239.50±213.27)ng/ml、(37.06± 21.60)ng/ml、(632.11± 293.20)pg/ml;AS组分别为(1.32± 0.57)ug/L、(63.34± 31.02)ng/ml、(19.48± 8.04)ng/ml、(125.20± 6.57)pg/ml;对照组为(0.17± 0.06)ug/L、(30.02± 15.23)ng/ml、(14.06± 3.19)ng/ml、(47.52± 21.30)pg/ml;ACS 组患者血清cTnⅠ、CK-MB、MYO及BNP水平及阳性率均高于SA 组和健康对照组,组间差异有统计学意义(P<0.05);cTnⅠ的ROC曲线下面积(AUC)为(0.917± 0.025),高于BNP 曲线下面积(0.823± 0.031)(P=0.037);4 项指标联合检测ACS 患者的敏感度(92.3%),高于单项检测86.0%(P<0.05)。结论:检测血清cTnⅠ、CK-MB、MYO及BNP对于判定心肌缺血和损伤程度有重要价 值,各项指标之间有互补作用,联合检测可为ACS 早期诊断提供参考依据。
英文摘要:
      Objective:To investigate the clinical significance of the combind detection of cardiac troponinⅠ (cTnⅠ ), creatine kinase isoenzyme-MB (CK-MB), myoglobin(MYO) and beta-type natriuretic peptide (BNP) in the diagnosis of acute coronary syndrome (ACS).Methods:The serum of 76 patients with definite diagnosis of ACS (ACS group), 32 patients with definite diagnosis of stable angina (SA group) and 35 healthy controls (control group) were detected for cTnⅠ, CK-MB, MYO and BNP levels by immuni-chemical luminescence method. The sensitivity and specificity of 4 paraimeters were evaiuated by receiver operating characteristic (ROC) curve.Results:The levels of cTnⅠ, CK-MB, MYO and BNP of ASC group were(9.27± 7.25)ug/L,(239.50± 213.27)ng/ml, (37.06± 21.60) ng/ml,(632.11± 293.20)pg/ml respectively and those of AS group were(1.32± 0.57)ug/L, 63.34± 31.02)ng/ml,(19.48± 8.04)ng/ml, (125.20± 6.57)pg/ml and those of control group were(0.17± 0.06)ug/L,(30.02± 15.23)ng/ml,(14.06± 3.19)ng/ml,(47.52± 21.30) pg/ml. The levels of cTnⅠ, CK-MB, MYO and BNP showed statistical difference between ACS group and health controls(P<0.01), and its positive rates was higher compored with those in ACS group. The area under ROC curve (AUC) of cTnⅠ (0.917± 0.025), was significantly higher than that of conventional BNP (0.823 ± 0.031, P=0.037). The sensitivity of combined detection was 92.3%in ACS diagnosis, which was higher significantly than that the individual detection (86.0%).Conclusion:The combined determination of the serumcTnⅠ, CK-MB, MYO and BNP has complementation significance in doagnosis of myccardial ischemia and myocoardial injury.
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