hs-TnT CK-MB NT-proBNP联合检测诊断急性心肌梗死的临床价值  

Clinical value of combined detection of hs-TnT, CK-MB and NT-proBNP in the diagnosis of acute myocardial infarction

作　　者：杨青[1] 吕树志[1] 张金华[1] 赵庚 Yang Qing;Lv Shuzhi;Zhang Jinhua;Zhao Geng(Nanyang Second People's Hospital,Nanyang 473000,Henan,China)

机构地区：[1]南阳市第二人民医院,河南南阳473000

出　　处：《临床心身疾病杂志》2022年第6期122-125,共4页Journal of Clinical Psychosomatic Diseases

基　　金：河南省医学科技攻关计划项目(编号201504011)。

摘　　要：目的 探讨高敏肌钙蛋白T、肌酸激酶同工酶、N末端脑钠钛前体联合检测诊断急性心肌梗死的临床价值。方法 将218例胸痛患者根据《急性心肌梗死诊治指南》中相关诊断标准分为急性心肌梗死82例(研究组)和非急性心肌梗死136例(对照组)。两组患者入院时均行血浆高敏肌钙蛋白T、肌酸激酶同工酶、N末端脑钠钛前体检测,并进行Logistic回归分析探讨三者与急性心肌梗死的关系,绘制受试者工作特征曲线分析其对急性心肌梗死的诊断价值。结果 研究组患者血浆高敏肌钙蛋白T、肌酸激酶同工酶、N末端脑钠钛前体水平显著高于对照组(P<0.01)。Logistic回归分析显示,血浆高敏肌钙蛋白T、肌酸激酶同工酶、N末端脑钠钛前体与急性心肌梗死的发生呈显著正相关(P<0.01)。受试者工作特征曲线显示,血浆高敏肌钙蛋白T、肌酸激酶同工酶、N末端脑钠钛前体具有较高的诊断价值,曲线下面积分别为0.785(95%CI为0.618~0.998)、0.763(95%CI为0.613~0.949)、0.727(95%CI为0.572~0.924),三者联合检测的价值更高,曲线下面积为0.842,95%CI为0.743~0.954。结论 联合检测血浆高敏肌钙蛋白T、肌酸激酶同工酶、N末端脑钠钛前体诊断急性心肌梗死具有较高的临床价值。Objective To investigate the clinical value of combined detection of high-sensitivity troponin T(hs-TnT), creatine kinase isoenzyme MB(CK-MB) and N-terminal pro-B-type natriuretic peptide(NT-proBNP) in the diagnosis of acute myocardial infarction(AMI). Methods A total of 218 patients with chest pain were divided into 82 patients with AMI(study group) and 136 patients with non-AMI(control group) according to the relevant criteria of the guidelines for the diagnosis and treatment of acute myocardial infarction. All subjects were tested for hs-TnT, CK-MB and NT-proBNP in plasma at admission. Logistic regression analysis was performed to explore the relationship between AMI and the three factors, and receiver operating characteristic(ROC) curve was used to analyze its diagnostic value for AMI. Results Plasma hs-TNT, CK-MB and NT-proBNP in the study group were significantly higher than those in the control group(P<0.01). Logistic regression showed that plasma hs-TNT, CK-MB and NT-proBNP were significantly positive correlated with the occurrence of AMI(P<0.01). ROC curve showed that plasma hs-TNT, CK-MB and NT-proBNP had high diagnostic value. The area under the curve(AUC) was 0.785(95%CI: 0.618-0.998), 0.763(95%CI: 0.613-0.949) and 0.727(95%CI: 0.572-0.924), respectively. The value of combined detection of the three was higher, AUC was 0.842, and 95% CI was 0.743-0.954. Conclusions The combined detection of plasma hs-TnT, CK-MB and NT-proBNP has higher clinical value in the diagnosis of AMI.

关 键 词：急性心肌梗死 高敏肌钙蛋白T 肌酸激酶同工酶 N末端脑钠钛前体 

分 类 号：R542.22[医药卫生—心血管疾病] R446.1[医药卫生—内科学]