ROC曲线评价可溶性Lox-1在急性冠脉综合征早期诊断中的应用

ROC curve evaluate soluble Lox-1 as a biomarker for early diagnosis of acute coronary syndrome

目的运用受试者工作特征（receiveroperatingcharacteristic，ROC）曲线分析可溶性凝集素样氧化型低密度脂蛋白受体-1（solublelectin-likeoxidizedLDLreceptor-1，sLox-1）在急性冠脉综合征（acutecoronarysyndrome，ACS）早期诊断中的价值。方法选择我院经冠状动脉造影确诊的ACS患者68例，按发病至采血时间间隔分为3h以内和3-6h两组，另收集经冠状动脉造影排除ACS的患者40例作为对照组。分别检测血清sLox-1、肌钙蛋白Ⅰ（cardiactroponinⅠ，cTnⅠ）、肌红蛋白（myobin，Myo）水平。对各指标单独及“sLox-1＋cTnⅠ”和“Myo＋cTnⅠ”联合检测诊断ACS的诊断性能进行评价。结果ACS患者在发病3h以内和发病3-6h的血清sLox-1、cTnⅠ和Myo水平均高于对照组，且差异均有统计学意义（P均〈0．05）。发病3h内血清sLox-1诊断ACS的曲线下面积为0．951，敏感性（82．8％）、特异性（95．0％）等诊断性能参数均优于cTnⅠ和Myo。发病3h以内及3-6”sLox-1＋cTnⅠ”联合检测的ROC曲线下面积分别为0．951和0．971，且各诊断性能参数多优于“Myo＋cTnⅠ”联合检测。结论血清sLox-1水平诊断发病早期ACS具有较高的敏感性和特异性，与cTnⅠ联合检测时可以发挥互补作用。

Objective To evaluate the clinical value of soluble lectin-like oxidized LDL receptor-1 （sLox-1） for early diagnosis of acute coronary syndrome （ACS） by using the receiver operating characteristic （ROC） curve. Methods 68 cases ACS patients confirmed by coronary angiography （CAG） in our hospital were divided into two groups according to the time interval between onset of the disease and blood collection, the within 3 h group and the 3-6 h group, respectively. 40 patients who were ruled out of ACS by CAG were collected as the control group. Serum levels of sLox-1, cardiac troponin Ⅰ （cTnI） and myobin （Myo） were mea- sured. The diagnostic performance of index alone and ＂sLox-l＋eTnⅠ＂ and ＂Myo＋cTnⅠ＂ combination for ACS were evaluated. Results The levels of sLox-1, cTnI and Myo in within 3 h group and 3-6 h group after onset of ACS were all higher than in control group, and the differences all had statistical significance （Pall〈 0.05 ）. Within 3 h after onset of ACS, the area under the ROC curve for sLox-1 was 0.951, and the diagnostic perfor- mance indexes such as sensitivity （82.8%） and specificity （95.0%） were all better than cTnI and Myo alone. Within 3 h and 3-6 h after onset of ACS, the area under the ROC curve for ＂sLox-l＋cTnⅠ＂ combination was 0.951 and 0.971 respectively, and the diagnostic performance indexes were almost better than the ＂Myo＋eTnⅠ＂ combination. Conclusion Serum sLox-1 has higher sensitivity and specificity for diagnosis of the early stage of ACS. Further more, when combined with cTnⅠ sLox-1 may show its complementary effect.