联合检测RBP4、hs-CRP及α-HBDH在急性ST段抬高型心肌梗死中的临床意义  

Combined detection of RBP4,hs-CRP andα-HBDH in acute ST-segment elevation myocardial infarction

作　　者：李静[1] 黄晓明[2] 姜友珍[3] 骆福秀[1] 毛忠文[1] LI Jing;HUANG Xiao-ming;JIANG You-zhen;LUO Fu-xiu;MAO Zong-wen(Department of Emergency,Nanxishan Hospital,Guangxi Zhuang Autonomous Region,Guilin,Guangxi 541002;Department of Cardiology,Nanxishan Hospital,Guangxi Zhuang Autonomous Region,Guilin,Guangxi 541002;Department of Clinical Laboratory,Nanxishan Hospital,Guangxi Zhuang Autonomous Region,Guilin,Guangxi 541002,China)

机构地区：[1]广西壮族自治区南溪山医院急诊科,广西桂林541002 [2]广西壮族自治区南溪山医院心血管内科,广西桂林541002 [3]广西壮族自治区南溪山医院检验科,广西桂林541002

出　　处：《热带医学杂志》2021年第2期238-242,共5页Journal of Tropical Medicine

基　　金：广西医疗卫生适宜技术开发与推广应用项目(S201619)。

摘　　要：目的探究联合检测视黄醇结合蛋白(RBP4)、超敏C-反应蛋白(hs-CRP)及α-羟丁酸脱氢酶(α-HBDH)在急性ST段抬高型心肌梗死(STEMI)中的临床意义。方法选择2017年1月-2020年3月于广西壮族南溪山医院收治的150例STEMI患者为研究组,同期150名心功能正常者作为对照组,应用酶联免疫法测定RBP4、hs-CRP和α-HBDH的表达情况,采用全自动生化分析仪测定脂代谢指标和心功能指标情况,探究RBP4、hs-CRP和α-HBDH与脂代谢和心功能指标的相关性,并采用ROC曲线分析RBP4、hs-CRP和α-HBDH单独和联合对STEMI的诊断价值。结果研究组在RBP4、hs-CRP、α-HBDH、甘油三酯(TC)、总胆固醇(TG)、低密度脂蛋白固醇(LDL-C)和高密度脂蛋白固醇(HDL-C)以及左室舒张末期直径(LVEDD)上均显著高于对照组,而在左室射血分数(LVEF)上表现为显著低于对照组,差异均有统计学意义(P<0.05)。Pearson相关性分析显示,RBP4与hs-CRP、α-HBDH、TC、TG、LDL-C、LVEDD呈正相关性(P<0.05),与LVEF呈负相关性(P<0.05),而与HDL-C无相关性(P>0.05);hs-CRP与RBP4、α-HBDH、TC、TG、LDL-C、LVEDD呈正相关性(P<0.05),与LVEF和HDL-C呈负相关性(P<0.05);α-HBDH与hs-CRP、RBP4、TC、TG、LDL-C、LVEDD呈正相关性(P<0.05),与LVEF和HDL-C呈负相关性(P<0.05)。ROC曲线显示,三者联合指标曲线下面积(AUC)为0.816,灵敏度为92.13%,特异度为86.39%,均显著高于任何单一指标(P<0.05)。结论RBP4、hs-CRP及α-HBDH水平随病情的发展逐步升高,针对上述指标联合检测可有效诊断STEMI的发生,超敏在临床上值得推广。Objective To explore the clinical significance of combined detection of retinol binding protein 4(RBP4),hypersensitive C-reactive protein(hs-CRP)andα-hydroxy butyric acid dehydrogenase(α-HBDH)in acute ST-segment elevation myocardial infarction.Methods 150 STEMI patients were enrolled as study group;150 cases with normal cardiac function were selected as the control group.RBP4,hs-CRP andα-HBDH were determined by enzyme-linked immunoassay.Automatic life analyzer was used to measure lipid metabolism index and heart function index,explore the correlation between RBP4,hs-CRP andα-HBDH and lipid metabolism and heart function index;ROC curve was used to analyze the diagnostic values of RBP4,hs-CRP andα-HBDH alone or in combination for STEMI.Results In the study group,RBP4,hs-CRP,α-HBDH,triglycerides(TC),total cholesterol(TG),low density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)and left ventricular end-diastolic diameter(LVEDD)levels were significantly higher than those in the control group,while left ventricular ejection fraction(LVEF)level was significantly lower than that in the control group(P<0.05).Pearson correlation analysis showed that RBP4 was positively correlated with hs-CRP,α-HBDH,TC,TG,LDL-C and LVEDD(P<0.05),negatively correlated with LVEF(P<0.05),but not correlated with HDL-C(P>0.05).Hs-CRP was positively correlated with RBP4,α-HBDH,TC,TG,LDL-C and LVEDD(P<0.05),and negatively correlated with LVEF and HDL-C(P<0.05).α-HBDH was positively correlated with hs-CRP,RBP4,TC,TG,LDL-C and LVEDD(P<0.05),but negatively correlated with LVEF and HDL-C(P<0.05).The ROC curve showed that the combined AUC of the three indexes was 0.816,the sensitivity was 92.13%,and the specificity was 86.39%;all of which were significantly higher than the AUC(P<0.05).Conclusions The serum levels of RBP4,hs-CRP andα-HBDH gradually increased with the development of the disease.Combined detection of the above indicators could effectively diagnose the occurrence of acute ST-segment elevation myocardi

关 键 词：视黄醇结合蛋白4 超敏C-反应蛋白 心肌梗死 Α-羟丁酸脱氢酶 

分 类 号：R542.22[医药卫生—心血管疾病]