和肽素脑钠肽及高敏肌钙蛋白T在急性心肌梗死中的早期诊断价值  

Diagnostic value of copeptin, BNP and high sensitivity troponin T in patients at early stage of acute myocardial infarction

作　　者：陈学 龙静 韩朝辉 麦文惠 吴飞燕 杜梅英[2] 

机构地区：[1]海口市第三人民医院检验科, 海南571100 [2] 海口市人民医院检验科

出　　处：《中国急救医学》2016年第7期634-638,共5页Chinese Journal of Critical Care Medicine

摘　　要：目的：探讨检测血清和肽素（Copeptin）、脑钠肽（BNP）及高敏肌钙蛋白T（Hs-TnT）在急性心肌梗死（AMI）早期诊断中的应用。方法按随机数字表达法选取96例AMI患者就诊4 h内、1 d、3 d、7 d和健康对照组的静脉血，检测Copeptin、BNP及Hs-TnT水平，绘制受试工作特征曲线（ROC）评价Copeptin、BNP及Hs-TnT在AMI中的早期诊断价值，并应用多元Logistic回归分析AMI的独立危险因素。结果 AMI组4 h内、1 d、3 d、7 d血清Copeptin、BNP及Hs-TnT水平均明显高于对照组（P＜0.05）。AMI患者4 h内、1 d、3 d血清Copeptin、BNP及Hs-TnT水平均明显高于7 d（P＜0.01），且AMI患者4 h内、1 d血清BNP及Hs-TnT水平均明显高于3 d（P＜0.01）。ROC曲线分析显示，Copeptin的AUC（0.892）高于BNP（0.864）和Hs-TnT（0.858），临界值为14.7 pmol/L时，敏感度和特异度分别为90.2%、87.4%。多元Logistic回归分析，发现性别、Copeptin、BNP及Hs-TnT是发生AMI的独立预测因子，其OR值及95%CI分别为1.062（1.017-1.104）、1.057（1.004-1.136）、1.034（1.002-1.098）、1.120（1.065-1.178），P＜0.05。Spearman相关分析显示，Copeptin与BNP呈明显正相关（r＝0.604，P＜0.05），BNP与Hs-TnT呈明显正相关（r＝0.682，P＜0.05）；Copeptin与Hs-TnT无明显相关性（P＞0.05）；性别与Copeptin、BNP及Hs-TnT均无明显相关性（P＞0.05）。结论 Copeptin、BNP和Hs-TnT可作为AMI早期诊断的良好指标，是预测AMI的独立危险因素。Objective To investigate the diagnostic value of c-terminal portion of pro-vasopressin（copeptin）, brain natriureticpeptide（BNP）and high-sensitivity troponinT（Hs-TnT）in patients at the early stage of acute myocardial infarction （AMI）. Methods Random number expression method was used to select 96 cases of patients with AMI. The AMI patients and their healthy controls were detected serum copeptin, BNP and Hs-TnT levels within 4 hours, 1 day, 3 days and 7 days. The related operating characteristic curves（ROC）were respectively drawn to evaluate the diagnostic value of early copeptin, BNP and Hs-TnT in the AMI, and multivariate logistic regression analysis was done for the independent risk factors of AMI. Results The serum copeptin, BNP and Hs-TnT levels in AMI group within 4 hours, 1 day, 3 days, 7 days were all significantly higher than those in the control group（P〈0.05）. For AMI patients, serum copeptin, BNP and Hs-TnT levels within 4 hours, 1 day, 3 days were significantly higher than those of the 7 days（P〈0.01）, and serum BNP and Hs-TnT levels within 4 hours, 1day were significantly higher than those of the 3 days（P〈0.01）. ROC curve analysis showed that copeptin AUC（0.892）was higher than the BNP（0.864）and the Hs-TnT（0.858）, with critical value of 14.7 pmol/L;the sensitivity and specificity were 90.2%and 87.4%, respectively. Multivariate logistic regression analysis showed that gender, copeptin, BNP and Hs-TnT were independent predictors of AMI, 95% CI and OR were 1.062 （1.017 to 1.104）, 1.057 （1.004 to 1.136）, 1.034 （1.002 to 1.098）, 1.120（1.065 to 1.178）, P〈0.05. Spearman correlation analysis showed that copeptin and BNP were significantly positively correlated（r=0.604, P〈0.05）, BNP and Hs-TnT were significantly positively correlated （r=0.682, P〈0.05）. There was no significant correlation between copeptin and Hs-TnT （P〉0.05）, and there was no significant correlation between gender and copeptin, BNP and Hs-TnT （P〉0.05）. Con

关 键 词：和肽素 脑钠肽 肌钙蛋白T 急性心肌梗死 

分 类 号：R587.104[医药卫生—内分泌]