血清学指标对不稳定斑块的诊断价值  

Value of serum markers in diagnosing unstable plaques of coronary arteries

作　　者：高长征[1] 郭素峡[2] 

机构地区：[1]无锡市第四人民医院心内科,江苏无锡214000 [2]无锡市人民医院心内科,江苏无锡214023

出　　处：《岭南心血管病杂志》2013年第1期70-73,92,共5页South China Journal of Cardiovascular Diseases

摘　　要：目的以血管内超声-虚拟组织学(intravascular unltrasound-virtual histology,IVUS-VH)分析为参照,观察血清学指标对不稳定斑块的预测意义。方法纳入69例冠状动脉粥样硬化性心脏病(冠心病)患者,于入院后检测各项血清学指标后,行冠状动脉造影及IVUS-VH分析斑块性质,通过受试者工作曲线(ROC)分析各项指标对不稳定斑块的诊断意义以及联合检测血清学指标对不稳定斑块的诊断符合率。结果心脏型脂肪酸结合蛋白(heart-type fatty acid-binding protein,HFAP)、超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、肌钙蛋白(cardiac troponin,cTnI)受试者工作曲线下面积分别为0.833、0.692、0.647,P均<0.05。HFAP、hs-CRP、cTnI联合检测对不稳定斑块诊断的符合率为93.75%;HFAP及hs-CRP联合检测对不稳定斑块诊断的符合率为63.16%;hs-CRP及cTnI联合检测对不稳定斑块诊断的符合率64.52%;HFAP及cTnI联合检测对不稳定斑块诊断的符合率为66.67%。结论对不稳定斑块诊断,单项检测时HFAP最优,其次为cTnI,最后为hs-CRP;HFAP、cTnI、hs-CRP三者联合检测优于任意两者联合。Objectives To evaluate the value of serum markers in diagnosing unstable plaques of coronary arteries refen：ed to intravascular ultrasound-virtual histology （IVUS-VH）. Methods Totally 69 patients with coronary heart disease were examined for sermn markers [cardiac enzymes, high-sensitivity C-reactive protein （hs-CRP）, heart-type fatty acid-binding protein （HFAP） and so on ] after admission. Coronary angiography and IVUS-VH were also performd on them. The receiver operating characteristic curves （ROC） of serum markers were calculated by using IVUS-VH as gold standard to judge the diagnosis coincidence rate of unstable plaques by serum markers. Results Areas under the ROCs of HFAP, hs-CRP and cardiac troponin （cTn-I） were 0.833, 0.692 and 0.647 respectively （all P〈0.05）. Combined detection of the three markers, the diagnosis coincidence rate of unstable plaques was 93.75%. Combined detection of HFAP and hs-CRP, the diagnosis coincidence rate of unstable plaques was 63.16%. Combined detection of hs-CRP and cTn-I, the diagnosis coincidence rate of unstable plaques was 64.52%. Combined detection of HFAP and cTn-I, the diagnosis coincidence rate of unstable plaques was 66.67%. Conclusions Of the three markers for diagnosing unstable plaques of coronary arteries, hs-CRP is good, cTn-I is better, and HFAP is the best. Combination of the three markers is superior to combination of any of the two markers for diagnosing unstable plaques of coronary arteries.

关 键 词：冠状动脉疾病 心脏型脂肪酸结合蛋白 肌钙蛋白 超敏C反应蛋白 不稳定斑块 

分 类 号：R541.4[医药卫生—心血管疾病]