标题:CK-MB、BNP、MYO、H-FABP及hs-cTnI联合检测对早期急性心肌梗死的诊断价值
作者:陈力,杨静 (攀枝花市中心医院急诊科,四川 攀枝花 617067)
卷次:
2018年29卷17期
【摘要】 目的 探讨肌酸激酶同工酶(CK-MB)、钠尿肽(BNP)、肌红蛋白(MYO)、心脏型脂肪酸结合蛋白(H-FABP)及高敏肌钙蛋白(hs-cTnI)联合检测急性心肌梗死(AMI)的临床意义。方法 选取攀枝花市中心医院急诊科 2015年 12月至 2017年 8月期间收治的 120例胸痛 3 h内的急诊患者,根据AMI诊断标准分为AMI组(n=67)及非AMI组(n=53)。收集两组患者的CK-MB、BNP、MYO、H-FABP及 hs-cTnI水平,分析 5种指标联合检测和单一检测的特异性及敏感性。结果 AMI组患者的CK-MB、BNP、MYO、H-FABP及 hs-cTnI水平均高于非AMI组,差异均具有统计学意义(P<0.05);CK-MB、BNP、MYO、H-FABP及 hs-cTnI联合检测的特异度、敏感度、约登指数分别为 90.91%、96.30%、0.87,联合检测的特异度、约登指数均高于单一CK-MB、BNP、MYO、H-FABP及 hs-cTnI单独应用时,差异均具有统计学意义(P<0.05);联合检测时的灵敏度高于BNP、MYO单独应用时(P<0.05)。结论 CK-MB、BNP、MYO、H-FABP及hs-cTnI联合检测对早期诊断急性心肌梗死具有较高的诊断价值。
【关键词】 肌酸激酶同工酶;钠尿肽;急性心肌梗死;临床意义
【中图分类号】 R542.2+2 【文献标识码】 A 【文章编号】 1003—6350(2018)17—2432—04
Clinical significance of combined detection of creatine kinase isozyme, brain natriuretic peptide, myoglobin,heart-type fatty acid binding protein and high-sensitivity cardiac troponin I in patients with early acutemyocardial infarction.
CHEN Li, YANG Jing. Department of Emergency, Panzhihua Central Hospital, Panzhihua 617067,Sichuan, CHINA
【Abstract】 Objective To investigate the clinical significance of combined detection of creatine kinase isozyme(CK-MB), brain natriuretic peptide (BNP), myoglobin (MYO), heart-type fatty acid binding protein (H-FABP) andhigh-sensitivity cardiac troponin I (hs-cTnI) in patients with early acute myocardial infarction (AMI). Methods A totalof 120 patients with chest pain within 3 hours treated in Department of Emergency, Panzhihua Central Hospital were se-lected from December 2015 to August 2017. According to the criteria of AMI diagnosis, they were divided into AMIgroup (n=67) and non-AMI group (n=53). The levels of CK-MB, BNP, MYO, H-FAB and hs-cTnI were collected, andthe specificity and sensitivity of the combined detection and single detection were analyzed. Results The levels ofCK-MB, BNP, MYO, H-FABP and hs-cTnI in AMI group were significantly higher than those of non-AMI group,with statistically significant differences (P<0.05). The specificity and sensitivity of combined detection, Youden indexof combined detection were 90.91%, 96.30%, 0.87, respectively. The specificity of combined detection was significant-ly higher than that of single CK-MB, BNP, MYO, H-FABP and hs-cTnI, with statistically significant difference (P<0.05). The sensitivity of combined detection was higher than that of BNP and MYO alone, with statistically significantdifference (P<0.05). Conclusion The combined detection of CK-MB, BNP, MYO, H-FABP and hs-cTnI has high di-agnostic value in early diagnosis of acute myocardial infarction, which is worthy of clinical popularization.
【Key words】 Creatine kinase isoenzyme (CK-MB); Natriuretic peptide (BNP); Acute myocardial infarction(AMI); Clinical significance·论 著·doi:10.3969/j.issn.1003-6350.2018.17.019基金项目:四川省攀枝花市科技局科研课题(编号:2015CY-S-19-8-5)
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