和肽素和肌钙蛋白Ⅰ及其联合检测在早期急性心肌梗死中的诊断价值分析  

Diagnostic value analysis of Copeptin,cTnI and the combined detection in the early acute myocardial infarction

作　　者：董演 陈梦飞[2] 陈占龙[2] 马育红[2] 张玲[2] 

机构地区：[1]宁夏医科大学,宁夏回族自治区银川市750001 [2]宁夏回族自治区人民医院(西北民族大学第一附属医院)急诊科

出　　处：《临床合理用药杂志》2017年第18期38-39,共2页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的探讨和肽素(Copeptin)、肌钙蛋白Ⅰ(cTnI)及其联合检测在早期急性心肌梗死(AMI)中的诊断价值。方法选取宁夏回族自治区人民医院2015年7—12月收治的"持续性胸痛4 h"患者132例,根据冠状动脉造影术(CAG)检查分为正常组(n=42)和AMI组(n=90)。检测比较两组患者Copeptin、cTnI水平,并分析Copeptin、cTnI及其联合检测在早期AMI中的诊断价值。结果 AMI组患者胸痛后4 h、6 h Copeptin和cTnI水平高于正常组(P<0.05)。以CAG结果为金标准,Copeptin联合cTnI检测的灵敏度为96.67%,特异度为80.95%,阳性预测值为91.58%,阴性预测值为91.89%,准确度为91.67%;单独Copeptin检测的灵敏度为91.11%,特异度为57.14%,阳性预测值为82.00%,阴性预测值为75.00%,准确度80.30%;单独cTnI检测的灵敏度为75.56%,特异度为71.43%,阳性预测值为85.00%,阴性预测值为57.69%,准确度为74.24%。结论患者胸痛4 h内,Copeptin联合cTnI检测有助于急诊AMI的快速筛选,提高AMI早期诊断率。Objective To investigate the diagnostic value of Copeptin,cTnI and the combined detection in the early acute myocardial infarction（AMI）.Methods A total of 132 cases of patients with chest pain for 4 h were admitted from July to December 2015 in Ningxia People＇s Hospital,which were divided into normal group（n=42） and AMI group（n=90） according to CAG detection.The Copeptin,cTnI were detected and compared between the two groups,and the diagnostic value of Copeptin,cTnI and the combined detection in the early AMI were analysized.Results After chest pain for 4 h,6 h,the AMI group of Copeptin and cTnI levels were higher than normal group（P〈0.05）.The results of CAG as gold standard,the Copeptin combined with cTnI detection of sensitivity was 96.67%,specificity was 80.95%,positive predictive value was 91.58%,negative predictive value was 91.89%,accuracy was 91.67%;the Copeptin detection of sensitivity was 91.11%,specificity was 57.14%,positive predictive value was 82.00%,negative predictive value was 75.00%,accuracy was 80.30%;the cTnI detection of sensitivity was 75.56%,specificity was 71.43%,positive predictive value was 85.00%,negative predictive value was 57.69%,accuracy was 74.24%.Conclusion Chest pain for 4 h of patients,Copeptin combined with cTnI detection is helpful to the rapid screening of AMI patients in Emergency Department,and improve the early diagnosis rate of AMI.

关 键 词：急性心肌梗死 和肽素 肌钙蛋白Ⅰ 诊断价值 

分 类 号：R542.22[医药卫生—心血管疾病]