心肌肌钙蛋白I与肌酸激酶同工酶质量、白细胞介素6及纤维蛋白原降解产物联合检测在急性心肌梗死诊断及治疗监测中的应用价值  

Application value of combined detection of troponin I,creatine kinase isoenzyme mass,interleukin-6 and fibrinogen degradation products in the diagnosis and treatment monitoring of acute myocardial infarction

作　　者：肖春 秦淑国[1] 胡恒贵[1] Xiao Chun;Qin Shuguo;Hu Henggui(Department of Laboratory Medicine,Wanbei Coal Power Group General Hospital,Anhui Suzhou 234000,China)

机构地区：[1]皖北煤电集团总医院检验科,安徽宿州234000

出　　处：《中国医师进修杂志》2021年第1期21-28,共8页Chinese Journal of Postgraduates of Medicine

基　　金：中关村国家自主创新示范区"重大前沿原创技术成果转化和产业化"项目(2019F000G403)。

摘　　要：目的:探讨心肌肌钙蛋白I(cTnI)与肌酸激酶同工酶质量(CKMBmass)、白细胞介素6(IL-6)、纤维蛋白原降解产物(FDP)联合检测在急性心肌梗死(AMI)诊断及治疗监测中的应用价值。方法:选取皖北煤电集团总医院2019年7月至2020年6月102例AMI患者作为AMI组,另选择同期就诊的胸痛(CP)、胸闷(CD)患者60例作为CPCD组,同期健康体检者60例作为健康对照组。比较三组外周血cTnI、CKMBmass、IL-6、FDP水平,采用受试者工作特征(ROC)曲线评价cTnI、CKMBmass、IL-6、FDP对AMI的诊断价值。AMI组均给予溶栓治疗,比较不同疗效患者的临床资料,治疗前后外周血cTnI、CKMBmass、IL-6、FDP水平变化,分析上述指标与临床指标及疗效的关系。结果:三组外周血cTnI、CKMBmass、IL-6、FDP水平比较差异有统计学意义( P<0.05);AMI组外周血cTnI、CKMBmass、IL-6、FDP水平最高,其次为CPCD组、健康对照组,组间比较差异均有统计学意义( P<0.05)。cTnI、CKMBmass、IL-6、FDP联合诊断CPCD、AMI的曲线下面积(AUC)值分别为0.898、0.926,均高于单一诊断。治疗有效患者发病至溶栓时间、梗死部位、糖尿病、入院时舒张压(DBP)、收缩压(SBP)、左室收缩期末容积(LVESV)、左室收缩末期内径(LVESD)、左室舒张末期容积(LVEDV)、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)与无效患者比较差异有统计学意义( P<0.05);有效患者入院时、治疗6 h、12 h、24 h、48 h、72 h后外周血cTnI、CKMBmass、IL-6、FDP水平低于无效患者,差异有统计学意义( P<0.05);入院时外周血cTnI、CKMBmass、IL-6、FDP与DBP、SBP、LVESV、LVESD、LVEDD、LVEDV呈正相关( P<0.05),与LVEF呈负相关( P<0.05);多元线性逐步回归分析结果表明,外周血cTnI、CKMBmass、IL-6、FDP水平与疗效显著相关( P<0.05)。 结论:AMI患者外周血cTnI、CKMBmass、IL-6、FDP水平升高,联合检测对AMI诊断及治疗监测具有指导性意义。Objective To explore the application value of combined detection of troponin I(cTnI)and creatine kinase isoenzyme mass(CKMBmass),interleukin-6(IL-6)and fibrinogen degradation products(FDP)in the diagnosis and treatment of acute myocardial infarction(AMI).Methods A total of 102 AMI patients in Wanbei Coal Power Group General Hospital from July 2019 to June 2020 were selected as the AMI group.In addition,60 patients diagnosed with chest pain(CP)and chest distress(CD)during the same period were selected as the CPCD group,and 60 healthy patients were selected as the healthy control group.The levels of cTnI,CKMBmass,IL-6 and FDP in the peripheral blood of the three groups were compared,and the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of cTnI,CKMBmass,IL-6,and FDP.The AMI group was given thrombolytic therapy.The clinical data of patients with different curative effects,the trend of changes in peripheral blood cTnI,CKMBmass,IL-6 and FDP levels before and after treatment were compared,and the relationship between the above indicators and clinical indicators and curative effects were analyzed.Results The levels of peripheral blood cTnI,CKMBmass,IL-6 and FDP in the AMI group were higher than those in the CPCD group and the healthy control group,and the levels of peripheral blood cTnI,CKMBmass,IL-6 and FDP in CPCD group were higher than those in the healthy control group(P<0.05).The area under the curve(AUC)values of cTnI,CKMBmass,IL-6 and FDP in the combined diagnosis of CPCD and AMI were 0.898 and 0.926,respectively,which were higher than those of single diagnosis.The time from onset to thrombolysis,infarct location,diabetes,diastolic blood pressure(DBP),systolic blood pressure(SBP),left ventricular end systolic volume(LVESV),left ventricular end systolic diameter(LVESD),left ventricular end diastolic volume(LVEDV),left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)on admission of effective patients and ineffective patients were statistically

关 键 词：心肌梗塞 肌钙蛋白I 白细胞介素6 肌酸激酶同工酶质量 纤维蛋白原降解产物 

分 类 号：R542.22[医药卫生—心血管疾病]