骨髓相关蛋白对急性冠状动脉综合征的早期诊断价值

The Value of Myeloid-related Protein in the Early Diagnosis of Acute Coronary Syndromes

目的探讨骨髓相关蛋白对急性冠状动脉综合征的早期诊断价值。方法选取因胸痛发作3 h内就诊患者81例,行冠状动脉造影,根据临床最终诊断,将患者分为急性冠状动脉综合征组和非缺血性胸痛组。分别在胸痛0～3 h、3～6 h、6～12 h采血检测骨髓相关蛋白,比较不同时段、不同取样途径骨髓相关蛋白变化规律。结果胸痛0～3 h、3～6 h和6～12 h骨髓相关蛋白两组比较差异均有统计学意义(P<0.05)。冠状动脉血和同期外周静脉血骨髓相关蛋白比较差异有统计学意义(P<0.05)。绘制0～6 h骨髓相关蛋白受试者作业特征曲线,最适cut-off值为8.5 mg/L,受试者作业特征曲线下面积为0.898(95%CI 0.815～0.981),灵敏度为60.7%,特异度为95.0%。结论骨髓相关蛋白对急性冠状动脉综合征诊断具有较高的灵敏度,可作为诊断急性冠状动脉综合征的早期生化标志物。

Aim To investigate the value of myeloid-related protein（MRP） in the early diagnosis of acute coronary syndromes（ACS）. Methods 81 patients were sent to the hospital within three hours of acute chest pain in this study.These patients had undergone coronary angiography.According to final clinical diagnosis,patients were designated as ACS group and non-ischemic chest pain（NICP） group.Blood samples were detected for MRP in the chest pain 0-3 h,3-6 h,6-12 h time periods.Compare different time,different ways of MRP sampling variation to evaluate the value of MRP in the clinical diagnosis of ACS. Results MRP difference of ACS group had statistical significance compared with NICP group in the chest pain 0-3 h,3-6 h and 6-12 h time periods（P〈0.05）.13 cases of ACS coronary artery MRP levels difference were statistically significant compared with venous blood MRP levels（P〈0.05）.Receiver operating characteristic curve（ROC curve） analysis was used to determine the cut-off value of this assay for identifying individuals with ACS from NICP,sensitivity and specificity at the optimal cut-off value of 8.5 mg/L were 60.7% and 95.0%.The area under ROC curve was 0.898（95%CI 0.815-0.981）. Conclusions MRP had high sensitivity in the diagnosis of ACS.MRP can be regarded as a early diagnosis biochemical marker of ACS.