血液RDW,Hcy和NEFA水平联合检测在冠心病诊断中的应用

Application of Combined Detection of Blood RDW,Hcy and NEFA Levels in the Diagnosis of Coronary Heart Disease

目的探讨红细胞体积分布宽度(RDW)、同型半胱氨酸(Hcy)和游离脂肪酸(NEFA)联合检测在冠心病(CHD)诊断中的应用价值。方法选取2019年1~7月在玉林市第二人民医院住院治疗的CHD患者162例,同期选取健康体检者131例作为对照组。比较两组研究对象的RDW,Hcy和NEFA水平差异,采用受试者工作特征(ROC)曲线分析各指标对CHD的诊断价值。结果①CHD组RDW(%),Hcy(μmol/L)和NEFA(mmol/L)水平分别是13.2(12.50,14.40),12.45(10.28,15.70)和0.50(0.35,0.65),高于对照组[12.7(12.10,13.20),6.50(5.67,8.07),0.34(0.28,0.40)],差异均有统计学意义(F=-5.298,-11.411,-7.035,均P<0.01)。②ROC曲线下面积对冠心病诊断价值的排序为RDW+Hcy+NEFA>Hcy>NEFA>RDW,RDW的敏感度为35.2%,特异度为94.7%;Hcy的敏感度是94,4%,特异度为77.1%;NEFA的敏感度为66.7%,特异度为77.9%。RDW+Hcy+NEFA联合检测敏感度提高至96.3%。结论RDW,Hcy和NEFA联合检测可以提高对CHD的诊断效能,对CHD诊断具有较高的临床应用价值。

Objective To explore the application value of combined detection of red blood cell volume distribution width(RDW),homocysteine(Hcy)and nonestesterified fatty acid(NEFA)in the diagnosis of coronary heart disease(CHD).Methods From January 2019 to July 162 CHD patients who were hospitalized in the Second People’s Hospital of Yulin were selected,and 131 healthy subjects were selected as the control group.The differences in RDW,Hcy and NEFA levels between the two groups of subjects were detected.The diagnostic value of each index on CHD was analyzed by the receiver operating characteristic(ROC)curve.Results①The RDW(%),Hcy(μmol/L)and NEFA(mmol/L)levels in the CHD group were 13.2(12.50,14.40),12.45(10.28,15.70)and 0.50(0.35,0.65),which were higher than those in the control group[12.7(12.10,13.20),6.50(5.67,8.07),0.34(0.28,0.40)],the differences were statistically significant(F=-5.298,-11.411,-7.035,P<0.01).②The order of the area under the ROC curve for the diagnosis of coronary heart disease was RDW+Hcy+NEFA>Hcy>NEFA>RDW,the sensitivity of RDW was 35.2%,and the specificity was 94.7%,respectively.The sensitivity of Hcy was 94.4%,and specificity was 77.1%.The sensitivity of NEFA was 66.7%,and the specificity was 77.9%.The sensitivity of RDW+Hcy+NEFA combined detection was increased to 96.3%.Conclusion The combined detection of RDW,Hcy and NEFA can improve the diagnostic efficacy of CHD,and has higher clinical application value for the diagnosis of CHD.