血清MPO联合hs-TNT对老年急性心肌梗死病人的诊断价值  

Diagnostic value of serum MPO combined with hs-TNT in elderly patients with acute myocardial infarction

作　　者：鲍磊 孙才智 朱晨晨 秦海东 BAO Lei;SUN Caizhi;ZHU Chenchen;QIN Haidong(Emergency Department,Nanjing First Hospital,Nanjing 210006,China)

机构地区：[1]南京市第一医院急诊科,江苏省南京市210006

出　　处：《实用老年医学》2025年第2期144-147,152,共5页Practical Geriatrics

基　　金：江苏省医院协会2023年度医院管理创新研究课题资助项目(JSYGY-3-2023-262)。

摘　　要：目的探讨血清髓过氧化物酶(MPO)联合高敏肌钙蛋白T(hs-TNT)在老年急性心肌梗死(AMI)病人中的诊断价值。方法回顾性选取南京市第一医院2023年8月至2024年1月收治的老年疑似AMI病人122例,按照胸痛发作时间到就诊时间间隔分为<2 h组、2~6 h组、>6 h组,根据病人是否确诊为AMI分为AMI组和非AMI组,检测所有病人血清MPO、hs-TNT、磷酸肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)水平,并进行组间比较。绘制ROC曲线,评估血清MPO对老年AMI的诊断效能。结果在<2 h以及2~6 h组老年病人中,AMI病人的MPO水平均显著高于非AMI病人(P<0.05),2组间血清hs-TNT、CK及CK-MB水平差异无统计学意义(均P>0.05);在>6 h就诊的老年病人中,AMI病人及非AMI病人血清MPO、hs-TNT、CK及CK-MB水平差异均有统计学意义(均P<0.05)。ROC曲线分析结果显示,在<2 h及2~6 h就诊的病人中,MPO对AMI的诊断效能均较高,AUC分别为0.85、0.83(均P<0.001)。在>6 h就诊的老年病人中,MPO联合hs-TNT的诊断效能较高(AUC=0.88,P<0.001)。结论血清MPO是早期诊断老年AMI的可靠指标,对于就诊较晚的老年AMI病人,MPO需联合hs-TNT进行诊断。Objective To explore the diagnostic value of myeloperoxidase(MPO)combined with high-sensitivity troponin T(hs-TNT)in the elderly patients with acute myocardial infarction(AMI).Methods A total of 122 elderly patients with suspected AMI admitted to Nanjing First Hospital from August 2023 to January 2024 were retrospectively enrolled.According to the time from onset to admission,they were divided into<2 h group,2-6 h group and>6 h group.The serum levels of MPO,hs-TNT,creatine kinase(CK)and creatine kinase-MB(CK-MB)were detected in all patients and compared between AMI group and non-AMI group.Receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic efficacy of serum MPO level in elderly patients with AMI.Results Among the elderly patients admitted within 2 h and 2-6 h,the MPO level in AMI group was significantly higher than that in non-AMI group(P<0.05),while there were no significant differences in the levels of hs-TNT,CK and CK-MB between the two groups(all P>0.05).Among the elderly patients admitted after 6 h,there were significant differences in the levels of serum MPO,hs-TNT,CK and CK-MB between AMI group and non-AMI group(all P<0.05).The results of ROC curve analysis showed that in the patients admitted within 2 h and 2-6 h,MPO had a significantly high diagnostic efficacy for AMI,with AUC of 0.85 and 0.83 respectively(both P<0.001).In the elderly patients admitted after 6 h,MPO combined with hs-TNT had a significantly high diagnostic efficacy for AMI(AUC=0.88,P<0.001).Conclusions Serum MPO is a reliable indicator for the diagnosis of AMI in the elderly patients.For those elderly AMI patients with a long time from onset to admission,MPO needs to be combined with hs-TNT for diagnosis.

关 键 词：髓过氧化物酶 高敏肌钙蛋白T 急性心肌梗死 诊断 老年人 

分 类 号：R542.22[医药卫生—心血管疾病]