髓过氧化物酶在非 ST 段抬高急性冠状动脉综合征诊断和预后中的临床应用  

Clinical Application of Myeloperoxidase in Diagnosis and Prognosis of Non-ST Elevation Acute Cornary Syndromes

作　　者：喻红波[1] 刘阳[1] 罗俊卿[1] 刘新国[1] 简明[1] 黄美良[1] 罗旦[1] 李学峰[1] 

机构地区：[1]武警湖南总队医院检验科,长沙410006

出　　处：《现代检验医学杂志》2015年第3期77-79,共3页Journal of Modern Laboratory Medicine

基　　金：湖南省科技厅科技计划,项目编号：2013FJ3136.

摘　　要：目的：评价血清髓过氧化物酶（MPO）对非 ST 段抬高心肌梗死（NSTE MI）的诊断价值，并探讨其与非 ST 段抬高急性冠状动脉综合征（NSTE ACS）的预后关系。方法检测61例不稳定心绞痛（UAP）和54例 NSTE MI 患者血清髓过氧化物酶（MPO）和心肌肌钙蛋白（cTnI）水平，应用受试者工作特征曲线（ROC Curve）比较 MPO 和 cTnI 对 NSTE MI 的价值；同时随访比较106例 NSTE ACS 患者1年内发生主要心脏不良事件的发生情况。结果NSTE MI 组与 UAP 组MPO 值分别为672±418 ng／ml 和459±328 ng／ml，差异有统计学意义（t ＝3.928，P ＜0.001）。cTnI 值分别为558±261 pg／ml 和405±278 pg／ml，差异均有统计学意义（t＝3.089，P ＝0.003）。ROC 曲线分析结果显示 MPO 诊断 NSTE MI 的最佳 cutoff 值382 ng／ml，此时曲线下面积0.726，敏感度92.6％，特异度39.8％；cTnI 的最佳 cutoff 值484 pg／ml，此时曲线下面积0.799，敏感度65.5％，特异度92.3％。MPO 是 NSTE ACS 患者1年内发生主要心脏事件的独立危险因子，风险比值（OR）3.085（95％ CI 1.585-5.662，P ＝0.032）。结论MPO 对 NSTE MI 的诊断具有较高敏感度，可辅助 cTnI诊断 NSTE MI，对 NSTE ACS 患者具有预后判断价值。Objective To evaluate the diagnostic value of myeloperoxidase （MPO）in diagnosis of non-ST elevation acute cor-onary syndromes （NSTE ACS）.Methods The MPO was determined in 61 unstable angina pectoris （UAP）patients and 54 non-ST-elevation myocardial infarction （NSTE MI）patients,then analyzed the data with receiver operationg characteristic curve （ROC curve）statistical software.The major adverse cardiac events （MACE）were obseved in 106 NSTE ACS patients through 1 year of follow-up.Results The MPO values of NSTE MI group and UAP group were 672±418 ng/ml and 459± 328 ng/ml,the difference was statistically significant （t=3.928,P 〈0.001）.The cTnI values were 558±261 pg/ml and 405 ±278 pg/ml of respectively.The difference was statistically significant （t = 3.089,P = 0.003）.The area under the ROC curve of MPO was 0.726 when the optimal cutoff value was 382 ng/ml in the diagnosis of NSTE MI.The sensitivity and specificity was 92.6% and 39.8%.The area under the ROC curve of cTnI was 0.799 when the optimal cutoff value was 484 ng/ml in the diagnosis of NSTE MI.The sensitivity and specificity was 65.5% and 92.3%.High MPO maintained a strong association with the risk of major adverse cardiac events through 1 year of follow-up.Conclussion MPO is ahigh sensitivity marker of the NSTE MI and of clinical value for prognosis of NSTE ACS.

关 键 词：非ST段抬高急性冠脉综合征 髓过氧化物酶 

分 类 号：R541.4[医药卫生—心血管疾病] R446.112[医药卫生—内科学]