血清同型半胱氨酸、超敏C反应蛋白和超敏肌钙蛋白I在急性心肌梗死的水平变化和意义  

Change and clinical significance of Hcy,hs-CRP and hs-TnI in patients with acute myocardial infarction

作　　者：高淑娟 柯春锦 姚艳敏[3] 江文艳[3] 曹翠青 Gao Shujuan Ke Chunjin Yao Yanmin Jiang Wenyan Cao Cunqing(Internal Medicine DePartment, Kaiping Hospital of Tangshan , Tangshan 063000, Chin)

机构地区：[1]河北省唐山市开平医院内科,063000 [2]华北理工大学 [3]唐山市人民医院心内科

出　　处：《中国综合临床》2017年第8期694-697,共4页Clinical Medicine of China

基　　金：河北省医学科学研究重点课题计划项目（20110620）

摘　　要：目的 探讨心肌梗死（AMI）患者血清中同型半胱氨酸（Hcy）、超敏C反应蛋白（hs-CRP）和超敏肌钙蛋白I（hs-TnI）水平变化及临床意义.方法 入选96例AMI患者为研究组,60例非AMI的冠心病患者为对照组.采集研究对象血液检测血清Hcy、hs-CRP和hs-TnI的含量,绘制ROC曲线并建立Logistic回归模型,分析各指标单独和联合检测在AMI诊断中的作用.结果 研究组Hcy、hs-CRP和 hs-TnI水平明显高于对照组,两组比较差异有统计学意义（t值分别为2.78、8.66和34.36,P均〈0.05）;Hcy、hs-CRP和 hs-TnI的曲线下面积分别为0.802 （95%CI为0.729~0.874）,0.71（95%CI为0.629~0.792）,0.929 （95%CI为0.891~0.967）,三者联合检测曲线下面积为0.971 （95%CI为0.950~0.992）.Hcy在AMI诊断中的敏感79%,特异性72%,hs-CRP的敏感性57%,特异性70%,hsTnI的敏感性87%,特异性90%,三者联合检测敏感性96%,特异性88%.结论 Hcy、hs-CRP和hs-TnI联合检测具有较好的互补作用,对AMI的诊断具有较高的特异性和敏感性.Objective To detect the change and clinical significance of homocysteine （Hcy）,hypersensitivity C response protein （hs-CRP） and hypersensitivity troponin I （hs-TnI） in patients with acute myocardial infarction （AMI）.Methods Ninety-six cases of AMI were selected as the research group and 60 cases of coronary heart disease without AMI were enrolled in the control group.Blood samples were collected to measure the contents of serum Hcy,hs-CRP and hs-TnI.ROC curve was drawn and Logistic regression model was established to analyze the role of each index alone and combined detection in the diagnosis of AMI.Results The levels of Hcy,hs-CRP and hs-TnI in the research group were significantly higher than those in the control group （Hcy： （29.29±7.65） mol/L vs.（17.23±4.68） mol/L;hs-CRP： （15.47±5.01） mg/L vs.（9.21±3.15） mg/L;hs-TnI： （40.88±9.18） ng/mL vs.（7.34±2.12） ng/mL,t=2.78,8.66,34.36,P〈0.05）.The area under the ROC curve of Hcy,hs-CRP,hs-TnI were 0.802 （95%CI（0.729~0.874））,0.71（95%CI（0.62~0.792））,0.929 （95%CI（0.891~0.967））,respectively.The area under the combine detection curve was 0.971 （95%CI,0.950~0.992）.The sensitivity of Hcy,hs-CRP and hs-TnI in the diagnosis of AMI were 79%,57%,87%,respectively,the specificity of the three groups were 72%,70%,90%,the sensitivity and specificity of combined detection were 96% and 88%.Conclusion Combined detection of Hcy,hs-CRP and hs-TnI plays a better role in the diagnosis of AMI than that of Hcy,hs-CRP,hs-TnI alone and has a high specificity and sensitivity in the diagnosis of AMI.

关 键 词：同型半胱氨酸 超敏C反应蛋白 超敏肌钙蛋白I 心肌梗死 ROC曲线 

分 类 号：R542.22[医药卫生—心血管疾病]