超声心动图联合cTnl、NT-pro BNP、D-二聚体在心血管急症诊断中的应用  

Diagnostic value of echocardiogram combined with cTnl,NT-pro BNP and D-dimer for cardiovascular emergencies

作　　者：潘奇峰 PAN Qifeng(Department of Cardiology,Wuzhou Gongren Hospital,Wuzhou 543001,China)

机构地区：[1]梧州市工人医院心内科,广西梧州543001

出　　处：《中国医学物理学杂志》2023年第5期576-579,共4页Chinese Journal of Medical Physics

基　　金：梧州市科技计划项目(202002077)。

摘　　要：目的:探讨并分析超声心动图联合肌钙蛋白(cTnl)、氨基末端脑钠肽前体(NT-pro BNP)、D-二聚体(D-D)检测在心血管急症诊断中的应用。方法:回顾性分析180例心血管急症患者,根据疾病类型不同分为急性心肌梗死(AMI)组(n=52)、急性心力衰竭(AHF)组(n=63)、急性主动脉夹层(AAD)组(n=28)及急性肺栓塞(APE)组(n=37)。采用超声心动图对所有患者予以检查,记录左室射血分数(LVEF)、左心室舒张末期内径值(LVEDd)及左心室收缩期末容积(LVESV);使用酶联免疫吸附试验法检测并比较患者的cTnl、NT-pro BNP及D-D水平,并记录4组患者在30 d内的生存率,采用受试者操作特征(ROC)曲线分析LVEF、cTnl、NT-pro BNP、D-D及其联合检测对心血管急症生存情况的诊断效能。结果:AMI组患者cTnl水平显著高于AAD组与APE组,D-D水平显著低于AAD组与APE组(P<0.05);AHF组患者NT-pro BNP水平显著高于AMI组、AAD组与APE组(P<0.05)。AMI组患者LVEF水平显著低于AHF组、AAD组和APE组(P<0.05),LVEDd、LVESV水平显著高于AHF组、AAD组和APE组(P<0.05)。AMI组、AHF组、AAD组及APE组30 d内的生存率分别为90.38%、90.48%、89.29%及91.89%(P>0.05)。ROC曲线显示cTnl、NT-pro BNP、D-D、LVEF、LVEDd、LVESV及其联合检测在诊断心血管急症患者生存中的ROC曲线下面积(AUC)分别为0.680、0.733、0.656、0.708、0.656、0.663、0.886。结论:超声心动图联合cTnl、NT-pro BNP、D-D在心血管急症诊断中有一定应用价值。Objective To explore and analyze the value of echocardiogram combined with cardiac troponin(cTnl),aminoterminal pro-brain natriuretic peptide(NT-pro BNP)and D-dimer(D-D)in the diagnosis of cardiovascular emergencies.Methods A retrospective analysis was performed on the 180 patients with acute cardiovascular diseases.According to different disease types,they were divided into acute myocardial infarction(AMI)group(n=52),acute heart failure(AHF)group(n=63),acute aortic dissection(AAD)group(n=28)and acute pulmonary embolism(APE)group(n=37).All underwent echocardiography for recording their left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDd)and left ventricular end-systolic volume(LVESV).The levels of cTnl,NT-pro BNP and D-D were detected using enzyme-linked immunosorbent assay.The survival rates within 30 d in the 4 groups were compared,and the diagnostic efficiencies of LVEF,cTnl,NT-pro BNP,D-D and combined detection for cardiovascular emergencies were analyzed using receiver operating characteristic(ROC)curves.Results Compared with AAD and APE groups,AMI group had a higher cTnl level and lower D-D level(P<0.05).The NT-pro BNP level in AHF group was significantly higher than that in AMI,AAD and APE groups(P<0.05).LVEF level was lower,and LVEDd and LVESV levels were higher in AMI group as compared with AHF,AAD and APE groups were 90.38%,90.48%,89.29%and 91.89%,respectively(P>0.05);and cTnl,NT-pro BNP,D-D,LVEF,LVEDd,LVESV and combined detection had an AUC of 0.680,0.733,0.656,0.708,0.656,0.663 and 0.886 for the diagnosis of cardiovascular emergencies.Conclusion The combination of echocardiogram with cTnl,NT-pro BNP and D-D is of great value in diagnosing cardiovascular emergencies.

关 键 词：超声心动图 肌钙蛋白 氨基末端脑钠肽前体 D-二聚体 心血管急症 

分 类 号：R541[医药卫生—心血管疾病]