联合检测NLR、hs-CRP、cTnI、MYO和BNP在急性心肌梗死中的早期诊断价值  

Early diagnostic value of combined detection of NLR,hs-CRP,cTnI,MYO and BNP in acute myocardial infarction

作　　者：吴晓[1] 王苏英[2] 李珊[2] WU Xiao;WANG Suying;LI Shan(Department of Laboratory,Lishui Central Hospital,Lishui Zhejiang 323000,China)

机构地区：[1]丽水市中心医院检验科,浙江丽水323000 [2]丽水市中心医院心脑血管病防治办公室,浙江丽水323000

出　　处：《中国急救复苏与灾害医学杂志》2022年第5期647-650,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：浙江省科技惠民计划项目(编号:2014H01009)。

摘　　要：目的探讨联合检测中性粒细胞与淋巴细胞比值(NLR)、高敏C反应蛋白(hs-CRP)、肌钙蛋白I(cTnI)、肌红蛋白(MYO)和脑钠肽(BNP)在急性心肌梗死(AMI)中的早期诊断价值。方法选取丽水市中心医院急诊科于2019年5月—2021年5月收治的AMI患者99例作为研究对象,其中ST段抬高型心肌梗死(STEMI)患者40例为STEMI组、非ST段抬高型心肌梗死(NSTEMI)患者59例为NSTEMI组,并选同期收治的不稳定型心绞痛(UA)患者62例作为UA组。收集研究对象的一般资料,检测各组NLR、hs-CRP、cTnI、MYO和BNP水平并进行比较。应用ROC曲线分析NLR、hs-CRP、cTnI、MYO和BNP单项及联合检测在早期诊断AMI的诊断效能。结果STEMI组和NSTEMI组的NLR、hs-CRP、cTnI、MYO和BNP水平均高于UA组,差异有统计学意义(P<0.05)。NLR、hs-CRP、cTnI、MYO、BNP和联合检测ROC曲线下面积分别为0.715(0.597~0.832)、0.534(0.407~0.660)、0.870(0.802~0.938)、0.804(0.714~0.894)、0.725(0.607~0.843)、0.903(0.827~0.979),联合检测特异度和敏感度最高,分别为92.1%和87.9%。结论联合检测NLR、hs-CRP、cTnI、MYO和BNP对AMI的早期诊断价值高于单项检测,可为临床诊断该病提供较为可靠的实验室诊断依据。Objective To explore the early diagnostic value of combined detection of neutrophil lymphocyte ratio(NLR),high sensitive C reaction protein(hs-CRP),cardiac troponin I(cTnI),myoglobin(MYO)and brain natriuretic peptide(BNP)in acute myocardial infarction(AMI).Methods Ninety-nine patients with AMI treated in Emergency Department of Lishui Central Hospital from May 2019 to May 2021 were selected as the research objects,including 40 patients with ST-segment elevation myocardial infarction(STEMI)as STEMI group and 59 patients with non ST segment elevation myocardial infarction(NSTEMI)as NSTEMI group.And 62 patients with unstable angina(UA)at the same time were selected as UA group.The general data of the subjects were collected,and the levels of NLR,hs-CRP,cTnI,MYO and BNP were detected and compared.ROC curve was used to analyze the diagnostic efficacy of NLR,hs CRP,cTnI,MYO and BNP in the early diagnosis of AMI.Results The levels of NLR,hs-CRP,cTnI,MYO and BNP in STEMI group and NSTEMI group were higher than those in UA group(P<0.05).The area under ROC curve of NLR,hs CRP,cTnI,MYO,BNP and combined examination was 0.715(0.597~0.832),0.534(0.407~0.660),0.870(0.802-0.938),0.804(0.714~0.894),0.725(0.607~0.843),0.903(0.827~0.979)respectively.The specificity and sensitivity of combined detection were the highest,92.1%and 87.9%respectively.Conclusion The value of combined detection of NLR,hs CRP,cTnI,MYO and BNP in early diagnosis of AMI is higher than that of single detection,which can provide more reliable laboratory diagnosis basis for clinical diagnosis of AMI.

关 键 词：肌钙蛋白 高敏C反应蛋白 急性心肌梗死 早期诊断 联合检测 

分 类 号：R446[医药卫生—诊断学]