联合检测血清胱抑素C 脑钠肽 肌钙蛋白Ⅰ及丁酰胆碱酯酶在急性心肌梗死患者中的诊断价值  

Diagnostic value of combined detection of serum serum cystatin C,B-type natriuretic peptide,cardiac troponin I and BChE in patients with acute myocardial infarction

作　　者：王静 于宏亮 朱俊 Wang Jing;Yu Hongliang;Zhu Jun(Department of Laboratory,Zhumadian Traditional Chinese Medicine Hospital,Zhumadian 463000,China)

机构地区：[1]驻马店市中医院检验科,驻马店463000

出　　处：《实用医技杂志》2024年第3期201-204,共4页Journal of Practical Medical Techniques

摘　　要：目的探讨血清胱抑素C(Cys-C)、脑钠肽(BNP)、肌钙蛋白I(cTnI)、丁酰胆碱酯酶(BChE)在急性心肌梗死(AMI)中的表达及临床意义。方法选取120例我院2021年1月至2022年12月收治的AMI患者为观察组,另选同期60例不稳定型心绞痛作为对照组、体检的60名健康者作为健康组。所有研究对象均采血检测Cys-C、BNP、cTnI及BChE水平,比较3组Cys-C、BNP、cTnI及BChE差异;比较Killip分级I、Ⅱ、Ⅲ级患者血清Cys-C、BNP、cTnI及BChE水平差异;并绘制受试者工作特征(ROC)曲线分析Cys-C、BNP、cTnI、BChE及联合检测在AMI中的诊断价值。结果观察组Cys-C、BNP、cTnI水平高于对照组、健康组[①Cys-C:观察组(1.57+0.19)mg/L、对照组(0.98±0.14)mg/L、健康组(0.65+0.11)mg/L;②BNP:观察组(418±26)pg/ml、对照组(152±14)pg/ml、健康组(89±7)pg/ml;③cTnZ:观察组(1.35±0.22)μg/L、对照组(0.42±0.08)μg/L、健康组(0.24±0.03)μg/L],BChE水平低于对照组、健康组[观察组(6.4±1.0)kU/L,对照组(12.4±1.2)kU/L,健康组(20.2±1.4)kU/L],差异有统计学意义(F=720.057、6778.287、1213.580、2655.764,P<0.05)。KillipⅢ级患者血清Cys-C、BNPcTnI水平高于Ⅱ级、I级患者[①Cys-C:Ⅱ级(2.02+0.24)mg/L,I级(1.22+0.14)mg/LⅡ级(1.52+0.18)mg/L;②BNP:Ⅱ级(586±31)pg/ml,I级(305±22)pg/ml,Ⅲ级(417±25)pg/ml;③cTnI:Ⅱ级(1.89+0.28)μg/L,级(0.95±0.14)μg/L,Ⅱ级(1.32+0.21)μg/L],BChE水平低于Ⅱ级、I级患者Ⅲ级(4.9+0.8)kU/L,I级(8.0±1.1)kU/,Ⅱ级(6.6±1.1)kU/L],差异有统计学意义(F=172.404、1080.093、185.790、83.699,P<0.05)。绘制R0C曲线显示,Cys-C、BNP、cTnI、BChE及联合检测诊断AMI的曲线下面积分别为:0.803、0.818.0.838、0.835、0.954,联合检测价值更高。结论血清Cys-C、BNP、cTnI、BChE在AMI患者中均存在异常表达,有助于疾病的早期诊断,且联合检测诊断价值更高。Objective To investigate the expression and clinical significance of serum cystatin C(Cys-C),B-type natriuretic peptide(BNP),cardiac troponin I(cTnI),and butyrylcholinesterase(BChE)in acute myocardial infarction(AMI).Methods Total of 120 AMI patients admitted to our hospital from January 2021 to December 2022 were selected as the observation group,60 unstable angina patients admitted during the same period were selected as the control group,and 60 healthy individuals who underwent physical examination during the same period were selected as the health group.All study subjects were subjected to blood sampling for detection of Cys-C,BNP,cTnI and BChE levels,and the differences in Cys-C,BNP,cTnI and BChE among the three groups were compared.We also compared the differences in serum Cys-C,BNP,cTnI,and BChE levels among Killip grade I,II,and II patients.ROC curves were used to analyze the clinical value of Cys-C,BNP,cTnI,BChE and combined detection in diagnosing AMI.Results The levels of Cys-C,BNP and cTnI in the observation group were(1.57±0.19)mg/L,(418±26)pg/ml,and(1.35±0.22)μg/L,respectively,higher than the control group[(0.98±0.14)mg/L,(152±14)pg/ml,(0.42±0.08)μg/L],healthy group[(0.65±0.11)mg/L,(89±7)pg/ml,(0.24±0.03)μg/L],the BChE level was(6.4±1.0)kU/L,lower than the control group(12.4±1.2)kU/L and the healthy group(20.2+1.4)kU/L,with statistically significant differences(F=720.057,6778.287,1213.580,2655.764,P<0.05).The serum levels of Cys-C,BNP,and cTnI in Killip Ⅲ patients were(2.02±0.24)mg/L,(586±31)pg/ml,and(1.89±0.28)μg/L,respectively,higher than Grade Ⅱ[(1.52±0.18)mg/L,(416±25)pg/ml,(1.32±0.21)μg/L],Grade I patients[(1.22±0.14)mg/L,(305±22)pg/ml,(0.95±0.14)μg/L],the BChE level was(4.9±0.9)kU/L,lower than that of grade I(6.6±1.1)kU/L and grade I patients(8.0±1.1)kU/L,with statistically significant differences(F=172.404,1080.093,185.790,83.699,P<0.05).ROC curves shows that the areas under the curves for Cys-C,BNP,cTnI,BChE and combined detection for diagnosing AMI are 0.803

关 键 词：心肌梗死 急性 胱抑素C 利钠肽 脑 临床表达 

分 类 号：R542.22[医药卫生—心血管疾病]