血清CK-MB、Hcy及cTnT联合检测在急性心肌梗死病情及预后评估中的作用  

Role of Combined Detection of Serum CK-MB,Hcy and cTnT in the Evaluation of the Condition and Prognosis of Acute Myocardial Infarction

作　　者：韩柯 杨倩 翟同宁 HAN Ke;YANG Qian;ZHAI Tong-ning(Department of Cardiovascular Medicine,Zhengzhou No.7 People's Hospital,Zhengzhou,Henan,450016,China)

机构地区：[1]郑州市第七人民医院心血管内科,河南郑州450016

出　　处：《中国血液流变学杂志》2024年第4期549-552,共4页Chinese Journal of Hemorheology

摘　　要：目的探究血清肌酸激酶同工酶MB(CK-MB)、同型半胱氨酸(Hcy)及心肌肌钙蛋白T(cTnT)联合检测在急性心肌梗死(AMI)病情程度及预后评估中的价值。方法选择2023年1月—2024年1月郑州市第七人民医院收治的AMI患者,共574例,作为观察组;另选取同时期76名健康体检者作为对照组。统计AMI患者90 d内主要不良心血管事件(MACE)发生情况,对比不同人群血清CK-MB、Hcy及cTnT的水平,采用ROC分析血清CK-MB、Hcy及cTnT预测AMI预后的效能。结果相对对照组,观察组CK-MB、Hcy、cTnT水平更高,差异有统计学意义(P<0.05);Gensini>40分者的CK-MB、Hcy、cTnT水平比Gensini≤40分者更高(P<0.05);PCI手术后发生MACE者事件者72例(12.54%),未发生MACE者的CK-MB、Hcy及cTnT水平比发生MACE者低(P<0.05);当CK-MB、Hcy及cTnT阈值分别为为14.63 mg/L、12.76μmol/L、6.13μg/L时,三者联合预测AMI的AUC值最高(0.798,95%CI:0.722~0.875),高于三者单一检测。结论通过评估手术前血清CK-MB、Hcy及cTnT水平,可为临床评估AMI患者病情程度、预后预测提供可靠资料。Objective To explore the value of combined detection of serum creatine kinase isoenzyme MB(CK-MB),homocysteine(Hcy)and cardiac troponin T(cTnT)in the evaluation of the severity and prognosis of acute myocardial infarction(AMI).Methods 574 patients with AMI admitted to Zhengzhou No.7 People's Hospital from January 2023 to January 2024 were selected as an observation group.At the same time,76 healthy subjects were selected as the control group.The incidence of major adverse cardiovascular events(MACE)in AMI patients within 90 days was counted.The levels of serum CK-MB,Hcy and cTnT in different groups were compared.The efficacy of serum CK-MB,Hcy and cTnT in predicting the prognosis of AMI was analyzed by ROC.Results Compared with the control group,the observation group had significantly higher levels of CK-MB,Hcy,and cTnT(P<0.05).The levels of CK-MB,Hcy and cTnT in patients with Gensini>40 were higher than those in patients with Gensini≤40(P<0.05).There were 72 cases(12.54%)with MACE after PCI.The levels of CK-MB,Hcy and cTnT in patients without MACE were lower than those in patients with MACE(P<0.05).When the cut-off values of CK-MB,Hcy and cTnT were 14.63 mg/L,12.76μol/L and 6.13μg/L,respectively,the AUC of the combination of the three was the highest(0.798,95%CI:0.722-0.875),which was higher than that of the single detection of the three.Conclusion Evaluation of CK-MB,Hcy and cTnT levels before operation can provide reliable data for clinical evaluation of the severity of AMI patients and prognosis prediction.

关 键 词：CK-MB HCY CTNT 急性心肌梗死 病情 预后 

分 类 号：R542.22[医药卫生—心血管疾病]