Hcy、hs-CRP及NT-proBNP在AMI患者并发急性心衰中的诊断价值  

Diagnostic value of Hcy,hs-CRP and NT-proBNP in AMI patients complicated with acute heart failure

作　　者：毛磊[1] 耿国英[1] 时静[1] 姬劲锐 赵秋霞[2] 刘恒亮[1] MAO Lei;GENG Guoying;SHI Jing;JI Jingrui;ZHAO Qiuxia;LIU Hengliang(Department of Cardiology,Zhengzhou People's Hospital,Zhengzhou,Henan,China,450003;Depart-ment of Health and Medicine,Zhengzhou People's Hospital,Zhengzhou,Henan,China,450003)

机构地区：[1]河南省郑州人民医院心血管内科二区,河南郑州450003 [2]河南省郑州市郑州人民医院健康医学部,河南郑州450003

出　　处：《分子诊断与治疗杂志》2022年第9期1582-1585,共4页Journal of Molecular Diagnostics and Therapy

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200678)。

摘　　要：目的 探讨联合检测急性心肌梗死(AMI)患者血清超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)、氨基末端脑钠肽前体(NT-proBNP)诊断并发急性心衰的临床价值。方法 选取在河南省郑州人民医院确诊的AMI患者148例,收集时间2020年1月至2021年8月,根据患者心功能Killips分级≥Ⅱ级的患者判断为心衰组57例、非心衰组91例,对比两组入院48 h内的血清hs-CRP、Hcy、NT-proBNP水平,并采用ROC曲线分析三者单独及联合应用早期诊断急性心衰的临床价值。结果 心衰组患者的血清hs-CRP、Hcy、NT-proBNP水平均显著的高于非心衰组患者,差异有统计学意义(t=4.412、7.899、13.613,P<0.05);心衰组患者的血清hs-CRP、Hcy与NT-proBNP水平均呈显著的正相关关系(r=0.592、0.634,P<0.05);绘制ROC曲线分析,血清hs-CRP的临界值取10.04 mg/L时,诊断AMI并发心衰的灵敏度为0.678、特异度为0.759、ROC曲线下面积为0.727;血清Hcy的临界值取1.62 mg/L时,诊断AMI并发心衰的灵敏度为0.704、特异度为0.793、ROC曲线下面积为0.753;血清NT-proBNP的临界值取3116.4 pg/mL时,诊断AMI并发心衰的灵敏度为0.790、特异度为0.880、ROC曲线下面积为0.843。血清hs-CRP、Hcy与NT-proBNP联合检测诊断AMI并发心衰患者的灵敏度为0.880、特异度为0.970、AUC值为0.934(P<0.05)。结论联合检测Hcy、hs-CRP及NT-proBNP对于早期预测AMI患者并发心衰具有重要的临床实用价值。Objective To explore the clinical value of combined detection of serum hs-CRP,Hcy and NT-proBNP in patients with acute myocardial infarction combined with acute heart failure. Methods A total of 148 cases of AMI patients were collected from January 2020 to August 2021,according to the Killips classification of cardiac function in patients with gradeⅡ,57 cases were set as the heart failure group,91 cases were the non-heart failure group,serum hs-CRP,Hcy and NT-proBNP levels were compared between two groups within 48 h after admission,and the clinical value of three parameters for the diagnosis of acute heart failure combined with the ROC curve were analyzed. Results The levels of serum hs-CRP,Hcy and NTproBNP in the heart failure group were significantly higher than those in the non-heart failure group,and the difference was statistically significant(t=4.412,7.899,13.613,P<0.05).Serum hs-CRP,Hcy and NT-proBNP levels in the heart failure group were significantly positively correlated(r=0.592,0.634,P<0.05). Drawing ROC curve analysis,when the critical value of serum hs-CRP was 10.04 mg/L,the sensitivity of diagnosing AMI complicated with heart failure was 0.678,the specificity was 0.759,and the area under the ROC curve was 0.727. When the critical value of serum Hcy was 1.62 mg/L,the sensitivity of diagnosing AMI complicated with heart failure was 0.704,the specificity was 0.793,and the area under the ROC curve was 0.753.When the critical value of serum NT-pro BNP was 3116.4 pg/m L,the sensitivity of diagnosing AMI complicated with heart failure was 0.790,the specificity was 0.880,and the area under the ROC curve was 0.843. The combined detection of serum hs-CRP,Hcy and NT-pro BNP had a sensitivity of 0.880,a specificity of 0.970 and an AUC value of 0.934(P<0.05)in the diagnosis of AMI complicated with heart failure. Conclusion Combined detection of Hcy,hs-CRP and NT-pro BNP has important clinical value for early prediction of AMI patients complicated with heart failure.

关 键 词：急性心肌梗死 超敏C反应蛋白 同型半胱氨酸 氨基末端脑钠肽前体 心衰 

分 类 号：R542.22[医药卫生—心血管疾病] R541.6[医药卫生—内科学]