急性冠脉综合征HMGB1、cTnI、BNP及hs-CRP表达及其诊断价值

Analysis of the Detection and prognosis of HMGB1,cTnI,BNP and hs-crp in 80 patients with acute coronary syndrome

目的:探讨急性冠脉综合征患者高迁移率族蛋白B1(HMGB1)、心肌肌钙蛋白I(cTnI)、B型脑钠肽(BNP)及超敏C-反应蛋白(hs-CRP)水平变化及预后,为患者的诊断提供指导。方法:选择2016年1月至2018年1月我院接诊的80例急性冠脉综合征患者为本研究对象,设为观察组。并选择我院同期体检健康者65例作为对照组。检测分析血清HMGB1、cTnI、BNP及hs-CRP在急性冠脉综合征患者中的变化。结果:观察组患者血清sHMGB1、cTnI、BNP及hs-CRP水平(7.41±3.51ng/mL、51.05±9.98ng/mL、83.57±11.91pg/mL、52.34±8.67mg/L)均明显高于对照组(3.09±1.57ng/mL、16.74±4.21ng/mL、34.57±8.17pg/mL、1.67±0.56mg/L);HMGB1诊断急性冠脉综合征的AUC为0.823,95%CI为0.753~0.893,cTnI诊断急性冠脉综合征的AUC为0.811,95%CI为0.740~0.883,BNP诊断急性冠脉综合征的AUC为0.825,95%CI为0.757~0.893,hs-CRP诊断急性冠脉综合征的AUC为0.841,95%CI为0.778~0.904,HMGB1+cTnI+BNP+hs-CRP诊断急性冠脉综合征的AUC为0.959,95%CI为0.931~0.988,HMGB1+cTnI+BNP+hs-CRP单独检测分别和联合检测曲线下面积比较,差异有统计学意义;联合检测的特异度、准确度分别为92.16%、94.35%;发生事件组患者血清sHMGB1、cTnI、BNP及hs-CRP水平(8.52±3.24ng/mL、63.51±10.54ng/mL、101.13±12.53pg/mL、62.21±9.67mg/L)均显著高于未发生事件组(6.79±2.57ng/mL、42.58±8.69ng/mL、68.35±10.25pg/mL、41.20±8.52mg/L)。结论:在急性冠脉综合征患者中HMGB1、cTnI、BNP及hs-CRP的表达和病情严重程度之间存在着密切关系,可促使疾病进展,而本次研究也为靶向药物治疗急性冠脉综合征提供了新思路,且联合检测具有较高的特异度、准确度,对急性冠脉综合征患者的预后判断具有重要价值,值得推广应用。

Objective To study Analysis of the Detection and prognosis of High mobility group box-1 protein(HMGB1),Cardiac troponin I(cTnI),b-type natriuretic peptide(BNP)and hypersensitive c-reactive protein(hs-CRP)in 80 patients with acute coronary syndrome.Methods 80 patients with acute coronary syndrome received in our hospital from January 2016 to January 2018 were selected as the study objects,and 65 healthy patients in our hospital were selected as the control group to analyze the changes of serum HMGB1,cTnI,BNP and hs-crp in patients with acute coronary syndrome.Results Serum sHMGB1,cTnI,BNP and hs-CRP levels(7.41±3.51ng/mL,51.05±9.98ng/mL,83.57±11.91pg/mL,52.34±8.67mg/L)in the observation group were significantly higher than those in the control group(3.09±1.57ng/mL,16.74±4.21ng/mL,34.57±8.17pg/mL,1.67±0.56mg/L),with statistically significant differences.The AUC of HMGB1 in the diagnosis of acute coronary syndrome was 0.823,95%ci was 0.753~0.893,the AUC of cTnI was 0.811,95%ci was 0.740~0.883,the AUC of BNP was 0.825,95%ci was 0.757~0.893,and the AUC of hs-CRP was 0.841,95%ci was 0.778~0.904.The AUC of HMGB1+cTnI+BNP+hs-crp in the diagnosis of acute coronary syndrome was 0.959,and the 95%CI was 0.931~0.988.The area under the curve of HMGB1+cTnI+BNP+hs-crp was significantly different from that of the combined detection.The specificity and accuracy of the combined detection were 92.16%and 94.35%,respectively.Serum sHMGB1,cTnI,BNP and hs-CRP levels(8.52±3.24ng/mL,63.51±10.54ng/mL,101.13±12.53pg/mL,62.58±8.69ng/mL 68.35±10.25pg/mL,41.20±8.52mg/L)were significantly higher in the event group than in the non-event group(6.79±2.57ng/mL,42.58±8.69ng/mL,68.35±10.25pg/mL,41.20±8.52mg/L),with statistically significant differences.Conclusion HMGB1 in patients with acute coronary syndrome,cTnI,BNP and hs-the expression of CRP and there is close relationship between disease severity,the disease can progress,and this study also provides targeted drug in the treatment of acute coronary syndrome with new ideas,and combined detection has higher specific degrees and accuracy,to judge the prognosis of patients with acute coronary syndrome(acs)has important value,worthy of popularization and application.