血清cTnI、CK-MB、hs-CRP联合SAA与LDH1在重症哮喘患者并发心肌损伤的相关性分析  

The Association Analysis of Serum cTnI,CK-MB,hs-CRP Combined with SAA and LDH1 in Patients with Severe Asthma Complicated with Myocardial Injury

作　　者：崔建英 高蓉[2] 牛黎明 张燕 CUI Jian-ying;GAO Rong;NIU Li-ming;ZHANG Yan(Department of Internal Medicine,Shenzhen Renhe Hospital,Shenzhen 518100,China;Department of Respiration,Neijiang Hospital of Traditional Chinese Medicine,Neijiang 641000,China;Department of Obstetrics and Gynecology,Shenzhen Renhe Hospital,Shenzhen 518100,China)

机构地区：[1]深圳仁合医院内科,广东深圳518100 [2]内江市中医医院呼吸内科,四川内江641000 [3]深圳仁合医院妇产科,广东深圳518100

出　　处：《标记免疫分析与临床》2019年第1期97-101,125,共6页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探究血清肌钙蛋白Ⅰ(cTnI)、磷酸肌酸激酶同工酶(CK-MB)、超敏C反应蛋白(hs-CRP)联合血清淀粉样蛋白A(SAA)与乳酸脱氢酶同工酶1(LDH1)在重症哮喘患者并发心肌损伤的相关性。方法选取2013年3月至2016年9月期间入院就诊的重症哮喘患者76例,同期收取健康体检者74例。运用受试者工作特征曲线(ROC)技术分析血清cTnl、CK-MB、hs-CRP、SAA与LDH1在鉴别诊断重症哮喘患者并发心肌损伤的临床价值。相关性分析采用Spearman检验。多项Logistic回归分析计算(OR)及其95%置信区间(CI)。结果重症哮喘合并心肌损伤组患者血清SAA和LDH1水平显著高于未合并心肌损伤组和健康组,此外,未合并心肌损伤组患者血清SAA水平显著高于健康组,差异均有统计学意义(P均<0.05)。ROC曲线分析显示,血清SAA和LDH1区分重症哮喘合并心肌损伤者与重症哮喘未合并心肌损伤者的AUC分别为:0. 901 (95%CI:0. 840～0. 963,P <0.001)和0. 786 (95%CI:0. 702～0. 871,<0. 001);灵敏度和特异性分别为:80.2%、98. 9%和79. 1%、87. 4%;临界值分别为:94. 8mg/L和50.1U/L。当联合血清cTnI、SAA、LDH1、CK-MB和hs-CRP时,区分重症哮喘合并心肌损伤者与重症哮喘未合并心肌损伤者的AUC为0.952(95%CI:0. 904～0. 999,P <0.001),在"并联"时,约登指数为最大值时的灵敏度和特异性分别为93. 6%和86.4%;在"串联"时,约登指数为最大值时的灵敏度为69.7%,特异性为100.0%。结论血清cTnI、CK-MB、hs-CRP联合SAA与LDH1对重症哮喘合并心肌损伤具有潜在的诊断价值,有望为重症哮喘患者合并心肌损伤的诊疗提供新的途径与思路。Objective To investigate the association of serum troponin I(cTnI),creatine phosphokinase-isoenzyme-MB(CK-MB),high-sensitivity C-reactive protein(hs-CRP)combined with serum amyloid A(SAA)and lactate Hydrogenase Isoenzyme 1(LDH1)in patients with severe asthma complicated with myocardial injury. Methods 76 severe asthmatic patients admitted to our hospital during the period from March 2013 to September 2016 were selected,and 74 healthy patients were collected during the same period.The clinical values of serum cTnI,CK-MB,hs-CRP,SAA,and LDH1 in the diagnosis of severe asthmatic patients complicated with myocardial infarction were analyzed by using receiver operating characteristic curve(ROC)technique.Spearman test was used for the correlation analysis.Multiple logistic regression analysis(OR)and its 95% confidence interval(CI)were calculated. Results Serum SAA and LDH1 levels in patients with severe asthma complicated with myocardial injury were significantly higher than those in patients without myocardial injury and healthy controls.In addition,serum SAA levels in patients without myocardial injury were significantly higher than those in healthy controls,with statistically significant differences( P <0.05).The ROC curve analysis showed that the AUC of serum SAA and LDH1 in distinguishing between severe asthma complicated with myocardial injury and severe asthma without myocardial injury were 0.901(95% CI: 0.840-0.963 , P <0.001)and 0.786(95% CI:0.702-0.871, P <0.001).The sensitivity and specificity were 80.2%/ 98.9% and 79.1%/ 87.4%,respectively.The critical values were 94.8 mg/L and 50.1 U/L,respectively.When combined with serum cTnI,SAA,LDH1,CK-MB,and hs-CRP,the AUC in distinguishing between severe asthma combined with myocardial injury and severe asthma without combined myocardial injury was 0.952(95% CI:0.904-0.999, P <0.001).In the “parallel”,the sensitivity and specificity were 93.6% and 86.4% respectively when the Youden index was maximal.In the “tandem”,the sensitivity was 69.7% and the specificity

关 键 词：血清淀粉样蛋白A 乳酸脱氢酶同工酶1 重症哮喘 心肌损伤 相差性分析 

分 类 号：R562.25[医药卫生—呼吸系统]