AMI患者的血清cTnT、BNP水平检测及对冠状动脉狭窄程度的诊断价值分析  

Detection of serum cTnT and BNP levels in AMI patients and analysis on their value for diagnosing coronary stenosis degree

作　　者：张晓松[1] 李霞[1] ZHANG Xiaosong;LI Xia(Department of Clinical Laboratory,Three Gorges Central Hospital,Chongqing 404000,China)

机构地区：[1]重庆三峡中心医院检验科,重庆404000

出　　处：《检验医学与临床》2020年第10期1340-1344,1347,共6页Laboratory Medicine and Clinic

摘　　要：目的检测急性心肌梗死(AMI)患者血清肌钙蛋白T(cTnT)、B型脑钠肽(BNP)水平,探讨其对AMI患者冠状动脉(以下简称冠脉)狭窄程度的诊断价值。方法选择2017年1月至2019年5月该院心内科收治的91例AMI患者,根据冠脉造影结果将AMI患者分为A组[冠脉Ⅰ级狭窄(50.00%≤冠脉狭窄率<70.00%)]和B组[冠脉Ⅱ~Ⅳ级狭窄(冠脉狭窄率≥70.00%)],另选择100例健康志愿者为对照组。所有受试者均检测血清cTnT、BNP水平并比较组间差异,采用Logistic回归分析血清cTnT、BNP水平与AMI患者冠脉狭窄程度的相关性,受试者工作特征(ROC)曲线分析血清cTnT、BNP水平诊断AMI患者冠脉狭窄程度的效能。结果 A组40例,B组51例。A、B组患者血清cTnT、BNP水平均高于对照组(P<0.05),A组患者血清cTnT、BNP水平低于B组(P<0.05)。Logistic回归分析结果显示UA、心脏外科与介入治疗狭窄冠脉研究(SYNTAX)积分、cTnT、BNP水平升高是AMI患者冠脉狭窄率≥70.00%的危险因素(P<0.05)。ROC曲线分析结果显示cTnT、BNP诊断AMI患者冠脉狭窄率≥70.00%的曲线下面积为(AUC)为0.722、0.810,灵敏度分别为80.39%、88.24%,特异度分别为75.00%、80.00%。结论 AMI患者血清cTnT、BNP明显升高,其水平与AMI患者冠脉狭窄程度密切相关,可作为评估AMI患者冠脉狭窄程度的敏感指标。Objective To determine the serum levels of troponin T(cTnT)and B-type brain natriuriritic peptide(BNP)in the patients with acute myocardial infarction(AMI),and to investigate their values for diagnosing the coronary artery stenosis degree.Methods Ninety-one patients with AMI admitted to the cardiology department of this hospital from January 2017 to May 2019 were selected and divided into the group A [coronary artery gradeⅠstenosis(50.00%≤coronary artery stenosis rate<70.00%)]and B[coronary artery gradeⅡ-Ⅳstenosis(coronary stenosis rate≥70.00%)]according to the coronary angiography results,and 100 healthy volunteers were selected as the control group.All subjects conducted the detection of serum cTnT and BNP levels and the differences were compared among the groups.The Logistic regression was used to analyze the correlation between serum cTnT and BNP levels with the degree of coronary artery stenosis in the patients with AMI.The receiver operating characteristics(ROC)curve was used to analyze the efficiency of serum cTnT and BNP levels in diagnosing the degree of coronary artery stenosis in the patients with AMI.Results The group A had 40 cases and group B had 51 cases.Serum cTnT and BNP levels in the group A and B were higher than those in the control group(P<0.05),while which in the group A were lower than those in the group B(P<0.05).The Logistic regression analysis results showed that UA,SYNTAX integral,cTnT and BNP were the risk factors for coronary stenosis rate≥70.00%in AMI patients(P<0.05).The ROC analysis results showed that the areas under the curve(AUC)of cTnT and BNP for diagnosing thecoronary stenosis rate≥70.00% in the patients with AMI were 0.722 and 0.810 respectively,the sensitivities were 80.39% and88.24%,and the specificities were 75.00%and 80.00%,respectively.Conclusion Serum cTnT and BNP levels are significantly increased in the patients with AMI,and their levels are closely correlated to the degree of coronary stenosis,which can serve as the sensitive indexes for evaluating the

关 键 词：急性心肌梗死 肌钙蛋白 脑钠肽 冠状动脉 狭窄程度 

分 类 号：R446.1[医药卫生—诊断学]