血清Hcy及Cys-C联合cTnI在老年急性呼吸衰竭患者心肌损伤中的预测价值分析  

Prediction value of serum Hcy,Cys-C,and cTnI in myocardial injury in elderly patients with acute respiratory failure

作　　者：陈海鹏[1] 王宝莹 蓝帆 CHEN Hai-peng;WANG Bao-ying;LAN Fan(Department of Cardiology,the Third People's Hospital of Luohe City,Luohe,Henan 462000,China)

机构地区：[1]漯河市第三人民医院心内科,河南漯河462000

出　　处：《医药论坛杂志》2024年第21期2246-2250,共5页Journal of Medical Forum

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20190089)。

摘　　要：目的 分析血清同型半胱氨酸(homocysteine, Hcy)、胱抑素C(cystatin-C,Cys-C)及心肌肌钙蛋白I(cardiac troponin I,cTnI)与老年急性呼吸衰竭患者心肌损伤的相关性。方法 本研究选取2018年10月至2023年10月漯河市第三人民医院就诊的老年急性呼吸衰竭病患89例为调查对象,将未发生心肌损伤的病患纳入对照组(n=58),发生心肌损伤的病患纳入观察组(n=31)。比较两组一般资料及血清Hcy、Cys-C及cTnI水平,分析老年急性呼吸衰竭病患发生心肌损伤的独立危险因素,评估血清标志物在老年急性呼吸衰竭病患发生心肌损伤的诊断效能。结果 观察组高血压比例显著高于对照组(P<0.05)。对照组血清Hcy、Cys-C及cTnI水平分别为(11.99±1.75)μmol/L、(1.33±0.19)mg/L及(0.07±0.01) U/L,观察组血清Hcy、Cys-C及cTnI水平分别为(18.50±2.80)μmol/L、(1.46±0.21) mg/L及(1.31±0.13) U/L;与对照组相比,观察组血清Hcy、Cys-C及cTnI水平均显著增加(P<0.01)。Pearson相关性分析显示观察组病患血清Hcy、Cys-C及cTnI水平两两之间均呈显著正相关(P<0.05)。二元logistic回归分析结果显示血清高水平的Hcy、Cys-C及cTnI为老年急性呼吸衰竭患者心肌损伤的危险因素(OR>1,P<0.05)。血清Hcy及Cys-C联合cTnI预测老年急性呼吸衰竭病患发生心肌损伤的曲线下面积为0.973(P<0.001),灵敏度为93.55%,特异性为93.10%。结论 血清Hcy、Cys-C及cTnI联合检测在老年急性呼吸衰竭患者并发心肌损伤中具有较高的诊断价值,可为临床该疾病的早期诊断提供理论依据。Objective To analyze the correlation between serum homocysteine(Hcy),cystatin C(Cys-C)and cardiac troponin I(cTnI)and myocardial injury in elderly patients with acute respiratory failure.Methods In this study,89 elderly patients with acute respiratory failure who were treated in the Third People’s Hospital of Luohe City from October 2018 to October 2023 were selected as the investigation objects.Patients with no myocardial damage were included in the control group(n=58),and patients with myocardial damage were included in the observation group(n=31).General data and serum levels of Hcy,Cys-C,and cTnI were compared between the two groups.Independent risk factors of myocardial injury in elderly cases with acute respiratory failure were analyzed,and the diagnostic value of serum indicators in elderly patients with acute respiratory failure complicated with myocardial injury was explored.Results The proportion of hypertension in observation group was markedly enhanced compared with that of the control group(P<0.05).The serum levels of Hcy,Cys-C,and cTnI in control group were(11.99±1.75)μmol/L,(1.33±0.19)mg/L,and(0.07±0.01)U/L,respectively.The serum levels of Hcy,Cys-C,and cTnI in the observation group were(18.50±2.80)μmol/L,(1.46±0.21)mg/L,and(1.31±0.13)U/L,respectively.Compared with that of the control group,the serum levels of Hcy, Cys - C, and cTnI in the observation group were prominently enhanced(P <0. 01). Pearson correlation analysisshowed that serum Hcy, Cys - C, and cTnI levels in the observation group were markedly positively correlated with eachother(P <0. 05). Binary logistic regression analysis showed that high serum levels of Hcy, Cys - C, and cTnI were riskfactors for myocardial injury in elderly patients with acute respiratory failure(OR >1, P <0. 05). The area under the curveof serum Hcy and Cys - C combined with cTnI predicted myocardial injury in elderly patients with acute respiratory failurewas 0. 973(P <0. 001), the sensitivity was 93. 55%, the specificity was 93. 10%. Conclusion Serum

关 键 词：老年人 急性呼吸衰竭 心肌损伤 血清同型半胱氨酸 胱抑素C 心肌肌钙蛋白I 

分 类 号：R563.8[医药卫生—呼吸系统]