血清cTnⅠ联合Hcy对非ST段抬高心肌梗死个体化诊断的价值研究

Study on value of combination detection of cardiac troponins Ⅰ and homocysteine in individual diagnosis of non-ST elevation myocardial infarction

目的探讨心肌钙蛋白I(cTnI)与同型半胱氨酸(Hcy)联合检测对提高非ST段抬高心肌梗死(NSTEMI)诊疗效果的作用。方法检测47例NSTEMI患者(NSTEMI组)在治疗前、后及63例健康体检者(对照组)的cTnI和Hcy水平,并通过统计学方法验证这两项指标对于判断NSTEMI诊疗效果的价值。结果 NSTEMI组血清cTnI为(2.37±0.65)ng/mL、Hcy为(19.23±2.94)μmol/L,均显著高于对照组的cTnI(0.33±0.14)ng/mL、Hcy(10.62±3.27)μmol/L,两组比较差异有统计学意义(P<0.05);单一cTnI与Hcy指标检测灵敏度分别为95.74%和85.11%,特异性分别为85.71%和90.48%;两项指标联合检测的灵敏度与特异性达到97.87%和98.41%;NSTEMI组治疗后的cTnI和Hcy水平均显著下降并接近正常水平。结论 cTnI和Hcy联合检测不仅可用于NSTEMI的诊断,而且对于NSTEMI的疗效判断具有重要意义。

Objective To discuss the effect of the combination detection of cardiac troponin I（cTnI） and homocysteine（Hcy） for increasing the diagnosis and treatment offects of non-ST elevation myocardial infarction（NSTEMI）. Methods The levels of cTnI and Hcy were detected in 4？ patients with NSTEMI（NSTEMI group） before and after therapy and 63 healthy individuals（control group）. The detection results were performed the statistical analysis for verifying their value to judge the diagnostic and treatment effect of NSTEMI. Results The levels of cTnI and Hcy were（2.37±0.65）ng/mL and（19.23±2.94） μmol/L in the NSTEMI group, which were significantly higher than（0.33 ±0. 14） ng/mL and （ 10.62± 3.27）μmol/L in the control group, the differences showing statistical significance（P〈0.05）;the sensitivities of single cTnI and Hcy were 95.74% and 85. 11%0 respectively, and their specificities were 85.71% and 90.48% respectively; the sensitivity and sepecificity of cTnI and Hey combination detection were risen to 97.87% and 98.41%respectively; after therapy, the cTnI and Hcy levels in the NSTEMI group were significantly lowered and close to the normal levels. Conclusion The combination detection of cTnI and Hcy can not only be used for the diagno- sis of NSTEMI,but also has the imoortant significance to the Judgment of the theraneNtiel effect of NSTEMI