神经诱导损伤蛋白1联合CK-MB检测在急性心肌梗死中的诊断价值  

Clinical diagnostic value of nerve-induced injury protein 1 combined with CK-MB detection in acute myocardial infarction

作　　者：张林敏 张凯楠 伏建峰[2] ZHANG Linmin;ZHANG Kainan;FU Jianfeng(Medical College,Shihezi University,Shihezi,Xinjiang 832000,China;Department of Military Clinical Laboratory Diagnosis Center,General Hospital of Xinjiang Military Region,Urumqi,Xinjiang 830000,China;Graduate School of Xinjiang Medical University,Urumqi,Xinjiang 830017,China)

机构地区：[1]石河子大学医学院,新疆石河子832000 [2]新疆军区总医院全军临床检验诊断中心,新疆乌鲁木齐830000 [3]新疆医科大学研究生院,新疆乌鲁木齐830017

出　　处：《检验医学与临床》2023年第20期2969-2972,2977,共5页Laboratory Medicine and Clinic

基　　金：全军后勤科研计划面上项目(CLJ19J028)。

摘　　要：目的观察神经诱导损伤蛋白1(Ninj1)在急性心肌梗死(AMI)患者血清中的表达水平,并分析Ninj1与AMI病情的相关性,评估其在AMI中的临床诊断效能。方法选取2022年7月至2023年3月于新疆军区总医院就诊的29例AMI患者作为AMI组,根据冠状动脉造影结果将AMI组患者按照Gensini评分中位数分为轻度狭窄组(15例)和中重度狭窄组(14例);29例非AMI患者作为对照组。所有研究对象均于入院后抽取肘静脉血4 mL,采用酶联免疫吸附试验检测血清Ninj1水平,分析Ninj1水平与AMI病情的相关性,并比较两组肌酸激酶同工酶(CK-MB)水平,分析血清Ninj1、CK-MB对MAI的诊断效能。结果AMI组Ninj1表达水平[91.92(31.89,224.84)pg/mL]明显高于对照组[46.10(30.86,87.96)pg/mL],差异有统计学意义(P<0.05);中重度狭窄组Ninj1表达水平明显高于轻度狭窄组,差异有统计学意义(P<0.05);Ninj1水平与Gensini评分呈正相关(r=0.587,P<0.05);Ninj1单独检测诊断AMI的曲线下面积(AUC)为0.657,灵敏度为62.10%,特异度为72.40%;Ninj1与CK-MB联合检测诊断AMI的AUC为0.989,灵敏度为93.10%,特异度为96.60%。Ninj1在AMI发病6 h内诊断AMI的AUC为0.812,灵敏度为84.60%,特异度为75.90%;此时段与CK-MB联合检测诊断AMI的AUC为0.989,灵敏度为92.30%,特异度为96.60%。结论Ninj1在一定程度上可用于AMI的临床诊断,并且可反映AMI病情的严重程度;血清Ninj1与CK-MB联合检测,可提高对AMI的诊断效能,Ninj1有可能是新型的AMI诊断生物标志物。Objective To observe the expression level of neuro-induced injury protein 1(Ninj1)in serum of patients with acute myocardial infarction(AMI),analyze the correlation between Ninj1 and AMI,and evaluate Ninj1 clinical diagnostic efficacy in AMI.Methods A total of 29 patients with AMI who were treated in the General Hospital of Xinjiang Military Region from July 2022 to March 2023 were selected as AMI group,according to the results of coronary angiography,AMI patients were divided into mild stenosis group(15 cases)and moderate to severe stenosis group(14 cases)according to the median Gensini score.And 29 non-AMI patients as control group.All subjects received 4 mL of venous blood after admission.Serum Ninj1 level was detected by enzyme-linked immunosorbent assay.The correlation between Ninj1 level and the condition of AMI was analyzed,and the levels of creatine kinase isoenzyme(CK-MB)were compared between the 2 groups,and analyzed the diagnostic efficacy of serum Ninj1 and CK-MB for AMI.Results The level of Ninj1 in AMI group[91.92(31.89,224.84)pg/mL]was significantly higher than that in control group[46.10(30.86,87.96)pg/mL](P<0.05).The expression level of Ninj1 in moderate to severe stenosis group was significantly higher than that in mild stenosis group(P<0.05).Ninj1 level was positively correlated with Gensini score(r=0.587,P<0.05).The area under the curve(AUC)of Ninj1 in the diagnosis of AMI was 0.657,the sensitivity was 62.10%,and the specificity was 72.40%.The AUC of combined detection of Ninj1 and CK-MB in the diagnosis of AMI was 0.989,the sensitivity was 93.10%,and the specificity was 96.60%.Ninj1 showed the AUC of Ninj1 in the diagnosis of AMI was 0.812 with in 6 h,the sensitivity in the diagnosis of AMI was 84.60%,and the specificity was 75.90%.The AUC of combined detection with CK-MB in the diagnosis AMI was 0.989,the sensitivity was 92.30%,and the specificity was 96.60%.Conclusion Ninj1 can be used in clinical diagnosis of AMI to a certain extent,and can reflect the severity of AMI diseases.The combined

关 键 词：神经诱导损伤蛋白1 急性心肌梗死 肌酸激酶同工酶 诊断生物标志物 

分 类 号：R542.22[医药卫生—心血管疾病]