血清BNP、MYO、cTnI诊断急性心肌梗死和预测主要心血管不良事件的价值  

Value of serum brain natriuretic peptide,myoglobin,and cardiac troponin I in diagnosing acute myocardial infarction and predicting major adverse cardiovascular events

作　　者：谢会娟 孙亚楠 李娜 XIE Hui-juan;SUN Ya-nan;LI Na(Department of Clinical Laboratory,Luohe Traditional Chinese Medicine Hospital,Luohe 462000,Henan,CHINA)

机构地区：[1]漯河市中医院检验科,河南漯河462000

出　　处：《海南医学》2024年第21期3121-3125,共5页Hainan Medical Journal

基　　金：河南省医学科技攻关计划项目(编号:LHGJ20210987)。

摘　　要：目的探究血清脑钠肽(BNP)、肌红蛋白(MYO)、肌钙蛋白I(cTnI)诊断急性心肌梗死(AMI)和预测患者预后的临床价值。方法回顾性分析2021年9月至2022年9月漯河市中医院收治的252例患者的临床资料,将其中168例AMI患者纳入AMI组,84例不稳定心绞痛患者纳入对照组,比较两组患者的血清BNP、MYO、cTnI水平,采用受试者工作特征(ROC)曲线分析血清BNP、MYO、cTnI水平诊断AMI的价值,对AMI组患者随访12个月,根据主要心血管不良事件(MACE)发生情况分为发生MACE组45例和未发生MACE组123例,采用二元Logistic回归分析MACE发生的危险因素,并通过ROC曲线分析血清BNP、MYO、cTnI水平预测MACE的价值。结果AMI组患者的血清BNP、MYO、cTnI水平分别为(164.93±51.85)ng/L、(88.28±23.63)μg/L、(4.75±1.38)ng/mL,明显高于对照组的(97.11±25.89)ng/L、(57.38±15.33)μg/L、(2.49±0.65)ng/mL,差异均有统计学意义(P<0.05);ROC曲线分析结果显示,血清BNP、MYO、cTnI水平诊断AMI的曲线下面积(AUC)分别为0.803、0.801、0.934,灵敏度/特异度分别为100.0%/50.0%、51.2%/100.0%、90.5%/89.3%;二元Logistic回归分析结果显示,年龄(≥60岁)、糖尿病史、发病至治疗时间、BNP、MYO、cTnI均是MACE的危险因素(P<0.05);ROC曲线分析结果显示,血清BNP、MYO、cTnI水平预测MACE的AUC分别为0.826、0.908、0.866,而联合数据预测MACE的AUC为0.964,灵敏度、特异度分别为91.9%、100.0%。结论血清BNP、MYO、cTnI水平可作为AMI临床诊断与预后预测的有效指标,联合检测预测预后价值更高。Objective To explore the clinical value of serum brain natriuretic peptide(BNP),myoglobin(MYO),and cardiac troponin I(cTnI)in diagnosing acute myocardial infarction(AMI)and predicting patients'prognosis.Methods A retrospective analysis was conducted on the clinical data of 252 patients admitted to Luohe Traditional Chinese Medicine Hospital from September 2021 to September 2022.Among them,168 patients with AMI were included in the AMI group,and 84 patients with unstable angina were included in the control group.The serum BNP,MYO,and cTnI levels of the two groups were compared,and the receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum BNP,MYO,and cTnI levels for AMI.The patients in the AMI group were followed up for 12 months and divided into a MACE group(n=45)and a non-MACE group(n=123)based on the occurrence of major adverse cardiovascular events(MACE).Binary logistic regression was used to analyze the risk factors for the occurrence of MACE,and ROC curve was used to analyze the value of serum BNP levels,MYO,and cTnI levels in predicting MACE.Results The serum levels of BNP,MYO,and cTnI in patients with AMI were(164.93±51.85)ng/L,(88.28±23.63)μg/L,and(4.75±1.38)ng/mL,respectively,which were significantly higher than(97.11±25.89)ng/L,(57.38±15.33)μg/L,and(2.49±0.65)ng/mL in the control group(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum BNP,MYO,and cTnI levels for diagnosing AMI were 0.803,0.801,and 0.934,respectively,with sensitivity/specificity of 100.0%/50.0%,51.2%/100.0%,and 90.5%/89.3%,respectively.Binary logistic regression analysis showed that age(≥60 years old),history of diabetes,time from onset to treatment,BNP,MYO,cTnI were all risk factors for MACE(P<0.05).ROC curve analysis showed that the AUC of serum BNP,MYO,and cTnI levels alone for predicting MACE were 0.826,0.908,and 0.866,respectively,while the AUC of combined detection of the three indexes for predicting MACE was 0.964(with sensitivity and specificity of 91.9%a

关 键 词：急性心肌梗死 脑钠肽 肌红蛋白 肌钙蛋白I 诊断 预后 临床价值 

分 类 号：R542.22[医药卫生—心血管疾病]