外周血血管性血友病因子裂解酶水平对急性心肌梗死的诊断效能  

Diagnostic efficacy of peripheral blood von Willebrand factor-cleaving protease in acute myocardial infarction

作　　者：李杰[1] 祖丽皮耶姆·希尔 海热尼沙·阿不都克日木[1] 排则莱提·艾海提 彭辉[1] LI Jie;Zulipiyemu·Xier;Hairenisha·Abudekerimu;Paizelaiti·Aihaiti;PENG Hui(People’s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,Xinjiang)

机构地区：[1]新疆维吾尔自治区人民医院,乌鲁木齐830001

出　　处：《山东医药》2020年第21期36-39,共4页Shandong Medical Journal

基　　金：新疆维吾尔自治区自然科学基金项目(2017D01C131)。

摘　　要：目的观察外周血血管性血友病因子裂解酶(ADAMTS13)水平对急性心肌梗死(AMI)的诊断效能。方法接受冠状动脉造影检查的患者374例,根据AMI诊断标准和冠状动脉造影检查结果分为AMI组(218例)和对照组(156例)。采用酶联免疫吸附实验检测两组患者外周血ADAMTS13,并作比较。收集两组患者的年龄、性别、BMI、高血压病史、糖尿病史、吸烟史、饮酒史等一般资料,肌酸激酶同工酶(CK-MB)、左心室射血分数(LVEF)、脑钠肽(BNP)、左室舒张期内径、D-二聚体、纤维蛋白原、血小板计数、血小板平均体积、血小板比积、空腹血糖、糖化血红蛋白、低密度脂蛋白、高密度脂蛋白、总胆固醇、甘油三酯等实验室检测指标,并作比较;将两组差异有统计学意义的指标作为自变量,以AMI为因变量,采用二分类Logistic回归分析法分析AMI的影响因素。采用受试者工作特征曲线(ROC)评价外周血ADAMTS13水平对AMI的诊断效能。结果AMI组患者外周血ADAMTS13水平为749.44(340.66,1395.31)ng/m L,对照组患者外周血ADAMTS13水平为1251.15(561.80,2431.81)ng/m L,两组相比,P<0.001。两组患者的平均年龄、男性占比、有糖尿病史、有吸烟史、有饮酒史、CK-MB、LVEF、BNP、左室舒张内径、D-二聚体、纤维蛋白原、血小板平均体积、血小板比积、空腹血糖、糖化血红蛋白、低密度脂蛋白、高密度脂蛋白、总胆固醇、甘油三酯等指标相比,P均<0.05。外周血ADAMTS13水平、甘油三酯水平、空腹血糖水平、纤维蛋白原水平、血小板比积是AMI的独立影响因素。外周血ADAMTS13水平诊断AMI的曲线下面积为0.64,取截断值为993.26 ng/m L时,外周血ADAMTS13水平诊断AMI的敏感度为62.6%、特异度为60.8%。结论AMI患者外周血ADAMTS13水平降低;外周血ADAMTS13水平、甘油三酯水平、空腹血糖水平、纤维蛋白原水平、血小板比积是AMI的独立影响因素;检测外周血ADAMTS13水�Objective To observe the diagnostic efficacy of von Willebrand factor-cleaving protease(ADAMTS13)level in acute myocardial infarction(AMI).Methods According to AMI diagnostic criteria and results of coronary angiography,374 patients were divided into the AMI group(n=218)and control group(n=156).The peripheral blood ADAMTS13 of the two groups was detected by ELISA and then was compared.General information such as age,sex,BMI,history of hypertension,history of diabetes,history of smoking and history of alcohol consumption were collected.Meanwhile,c K-MB,LVEF,BNP,left ventricular diastolic diameter,D-dimer,fibrinogen,platelet count,mean platelet volume,specific platelet volume,fasting glucose,Hb A1 c,LDL,HDL,TG,TC,and other laboratory test indicators were collected and compared.The influencing factors of AMI were analyzed by binary Logistic regression analysis by taking the indicators with statistically significant differences between the two groups as independent variables and AMI as dependent variables.The efficacy of peripheral ADAMTS13 level in diagnosis of AMI was evaluated by receiver operating characteristic(ROC)curve.Results The ADAMTS13 level in peripheral blood of patients with AMI was 749.44(340.66,1395.31)ng/m L,while that in peripheral blood of control group was 1251.15(561.80,2431.81)ng/m L,with statistically significant difference between theses two groups(P<0.001).The average age,male proportion,history of diabetes,history of smoking,history of alcohol consumption,CK-MB,BNP,left ventricular diastolic diameter,D-dimer,fibrinogen,fasting blood glucose,Hb A1 c,LDL,TG,and TC were higher in the AMI group than in the control group(all P<0.05).The levels of HDL,platelet mean volume,platelet specific volume,and LVEF in the AMI group were significantly lower than those in the control group(all P<0.05).ADAMTS13 level,TG level,fasting glucose level,fibrinogen level,and platelet specific volume in the peripheral blood were independent influencing factors for AMI.The area under the curve of peripheral blood ADAMT

关 键 词：血管性血友病因子裂解酶 血管性血友病因子 心肌梗死 急性心肌梗死 血栓 

分 类 号：R446.11[医药卫生—诊断学]