双向侧流免疫MPO参考区间的建立及MPO对AMI的临床价值探讨  

Establishment of reference range for myeloperoxidase(MPO) determined by bidirectional lateral flow lmmunoassay and MPO for the clinical value of AMI discussion

作　　者：包金[1] 单洪丽[1] 孙璐璐[1] 高海翟 金宇亭 黄晶[1] 

机构地区：[1]吉林大学第一医院,长春130021

出　　处：《山东医药》2014年第41期14-17,共4页Shandong Medical Journal

基　　金：吉林省科技厅资助项目(20110957)

摘　　要：目的建立双向侧流免疫髓过氧化物酶（MPO）参考区间,确定MPO对AMI的最佳诊断cut-off值,评价MPO对AMI患者的早期诊断价值,同时观察MPO水平与AMI预后的关系。方法用双向侧流MPO检测试剂测定来自吉林大学第一医院体检中心健康体检人群363例血浆MPO浓度（对照组）,363例健康人按照年龄分为〈30岁、30~39岁、40~49岁、50~59岁、60~69岁、≥70岁6组,按不同性别和年龄段进行统计分析,找出其参考区间。检测心肌梗死（AMI）组、不稳定心绞痛（UAP）组血浆中MPO浓度,通过ROC曲线找出MPO诊断AMI的最佳cut-off值。对AMI组MPO高水平患者进行电话随访,追踪MPO与AMI预后的关系。结果 MPO测定结果呈偏态分布,MPO水平在不同性别、各年龄组差异无统计学意义,故取单侧95百分位值为双向侧流免疫MPO参考区间,为小于23.10 ng/m L;AMI组和UAP组MPO高于对照组,AMI组高于UAP组（P均〈0.01）。MPO的ROC曲线下面积为0.761,对AMI最佳诊断cut-off值为28.82 ng/m L;在219例AMI组患者中,MPO阳性率0.808,c Tn I阳性率0.653,其中MPO阳性而c Tn I阴性的有50例。随访到AMI组MPO高水平患者81例,半年内15例再次发作AMI,其中3例死亡。结论双向侧流MPO参考区间为〈23.10 ng/m L,MPO对AMI最佳诊断cut-off值为28.82 ng/m L。MPO对AMI危险事件发生有早期提示价值,MPO增高可能是随后的1~6个月内发生严重心血管疾病危险性的独立指标,尤其是对c Tn I假阴性患者更有意义。Objective To established bidirectional lateral flow immune Myeloperoxidase（MPO） reference range,determine the best diagnostic cut-off value MPO for AMI,evaluate MPO early diagnostic value of patients with AMI,investigate the relationship between levels of MPO and prognosis of AMI.Methods Totally 363 health cases were collected from the first hospital of Jilin university medical examination center; all of the 363 plasma specimen MPO concentrations were measured by MPO kits.363 cases of healthy people by age are divided into 6 groups which included less then 30,30-39,40-49,50-59,60-69 and at the age of 70 or higher.According to the different gender and age,statistical analysis was to execute.The plasma MPO levels of Acute Myocardial Infarction（AMI） group,Unstable Angina Pectoris（UAP） group and control group are tested by the MPO kits.The measurement results were statistically analyzed using ROC curves.The patients with high MPO level in AMI group were followed-up by telephone,tracking the relationship between MPO and the prognosis of AMI.Results There was no statistically significant difference of MPO levels in different gender and age groups which was due to the measurement results of MPO skew distribution,taking unilateral 95 percentile values for bidirectional lateral flow immune MPO reference range,which is less than 23.10 ng / m L; There were obvious differences of MPO（P〈0.01） which were compared among AMI group and UAP group and control,respectively; the comparison results between AMI group and UAP group were show significant differences（all P〈0.01） as well.MPO in the area under the ROC curve is 0.761 and the best diagnosis of AMI cut-off value was 28.82 ng / m L.The positive rate of MPO was 0.808 and of c Tn I is 0.653 in the 219 cases of AMI patients,separately.There were 50 cases with MPO positive but with c Tn I negative.Totally 81 cases of patients with high MPO level were found,15 cases had a relapse in a half years after the onset of AMI.and 3 cases died.Conclusion Bidirectional

关 键 词：急性心肌梗死 免疫髓过氧化物酶 双向侧流免疫法 

分 类 号：R541.4[医药卫生—心血管疾病]