血清同型半胱氨酸、肌钙蛋白Ⅰ联合颈动脉粥样硬化检测在冠心病诊治中的应用价值研究  

Study on the Application Value of Combined Detection of Hcy,TnⅠand IMT in the Early Diagnostic Process of Coronary Heart Disease

作　　者：张计超 杜杰 ZHANG Ji-chao;DU Jie(Department of Clinical Laboratory,Anyang Dengta Hospital,Henan Province,Anyang 455000)

机构地区：[1]河南省安阳市灯塔医院检验科,安阳455000

出　　处：《实用中西医结合临床》2023年第13期80-83,87,共5页Practical Clinical Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的:探讨血清中同型半胱氨酸(Hcy)、肌钙蛋白Ⅰ(TnⅠ)与颈动脉内-中膜厚度(IMT)在冠心病诊断中的应用价值。方法:选取2021年11月至2022年11月在医院确诊的98例冠心病患者为冠心病组,并选取同时段在医院进行健康体检的100例正常人群作为对照组,回顾性分析其临床资料。比较两组基本资料、生化指标,并进行多元Logistic回归相关分析,最后统计学分析冠心病组患者单独或联合检测血清中Hcy、TnⅠ水平与IMT的诊断效能。结果:冠心病组收缩压(SBP)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、Hcy、TnⅠ水平与IMT均较对照组高(P<0.05),高密度脂蛋白胆固醇(HDL-C)较对照组低(P<0.05);经过多元回归分析,血清Hcy、TnⅠ水平、IMT与冠心病有关,是冠心病出现的独立危险因素;相较治疗前,治疗后冠心病组患者血清Hcy、TnⅠ水平与IMT均明显降低(P<0.05);在联合检测中,Hcy+TnⅠ+IMT三项指标联合检测敏感度、特异度、准确度最高(P<0.05),与单独检测比较,差异明显(P<0.05),且此时受试者工作特征(ROC)曲线面积最大。结论:血清Hcy、TnⅠ水平与IMT联合检测能明显提高冠心病的准确度、敏感度及特异度。Objective:To discuss the application value of serum homocysteine(Hcy),troponinⅠ(TnⅠ)and carotid intragastric media thickness(IMT)in the diagnosis of coronary heart disease.Methods:Ninety-eight patients with coronary heart disease diagnosed in hospital from November 2021 to November 2022 were selected as the coronary heart disease group,and 100 normal people who underwent physical examination in hospital during the same period were selected as the control group,and their clinical data were retrospectively analyzed.The basic data and biochemical indicators between the two groups were compared,and multiple Logistic regression correlation analysis was performed.Finally,the diagnostic efficacy of serum Hcy,TnⅠlevel and IMT alone or combined in patients with coronary heart disease group was statistically analyzed.Results:Systolic blood pressure(SBP),low density lipoprotein cholesterol(LDL-C),triglyceride(TG),Hcy,TnⅠlevel and IMT were higher in coronary heart disease group than in control group(P<0.05),but high density lipoprotein cholesterol(HDL-C)was lower than that in control group(P<0.05).After multiple regression analysis,serum Hcy,TnⅠlevel and IMT were associated with coronary heart disease,and were independent risk factors for coronary heart disease.Compared with before treatment,serum levels of Hcy,TnⅠand IMT in coronary heart disease group were significantly decreased after treatment(P<0.05).In the combined detection,the sensitivity,specificity and accuracy of the combined detection of Hcy+TnⅠ+IMT were the highest(P<0.05),and the difference was significanty compared with the single detection(P<0.05),and the receiver operating characteristic(ROC)curve area was the largest at this time.Conclusion:Serum Hcy,TnⅠlevel and IMT combined detection can significantly improve the accuracy,sensitivity and specificity of coronary heart disease.

关 键 词：冠心病 同型半胱氨酸 肌钙蛋白Ⅰ 颈动脉内-中膜厚度 

分 类 号：R541.4[医药卫生—心血管疾病]