摘要
目的了解大连心血管病诊疗中心成立2年来心脏诊断标志物在心脏急诊胸痛患者中的使用现状。从实验室诊断角度分析2013—2015年不同类型心脏病患者有无趋势变化,为临床合理筛选心脏诊断标志物提供参考依据。方法收集2013年11月—2014年10月于大连医科大学附属第一医院共检测急诊患者6 849,2014年11月—2015年10月共检测急诊患者8 077例,所有急诊胸痛患者的超敏肌钙蛋白I(hs-TnI)、B型钠尿肽(BNP)、肌红蛋白(MYO)、肌酸激酶同工酶-MB质量(CKMB)、心脏型脂肪酸结合蛋白(H-FABP)的阳性报告结果,评价2年来变化情况;并对常用的标志物TnI、BNP分别按性别、年龄、月份进行分类统计,应用SPSS 19.0统计学软件分析2年间阳性结果和临床应用的变化情况。结果临床对于MYO、H-FABP 3个指标的应用呈下降趋势;统计的心肌损伤标志物TnI阳性有一定的季节变化趋势,冬春季节高发(100例左右),而夏季减低(60例左右);并且性别差异有统计学意义,男性hs-TNI为(9.018±34.068)μg/L高于女性(P<0.01);女性患者中年龄差异有统计学意义,年老患者hs-TNI(8.87±32.11)μg/L高发于年轻患者(P<0.01);而心脏功能标志物BNP则在年龄和性别上差异无计学意义(P>0.05)。结论为提高确诊率,对不明原因的急诊胸痛患者,建议综合心血管不良事件的发生在季节、性别、年龄上的规律,有针对性地筛查和合理选择心脏诊断标志物,以确保早期诊断,避免误诊、延诊、漏诊。
Objective To know the current situation of using cardiac markers in emergency patients with chest pain from establishing Da Lian Cardiovascular Disease Consulting Centre.From the perspective of laboratory diagnosis,analyze the presence of trends in dif-ferent types of patients with heart disease between 2013 and 2015,and provide a reference for clinician reasonably selecting cardiac markers.Methods From November 2013 to October 2014 to the First Affiliated Hospital of Dalian Medical University were detected in emergency patients 6 849 cases, November 2014 to October 2015 were detected in emergency patients with 8 077 people, all patients with chest pain sensitive troponin I(hs-TnI), B type natriuretic peptide(BNP), myoglobin(MYO), creatine kinase isoenzyme-MB(CKMB quality), heart type fatty acid binding protein(H-FABP) positive results, evaluation of changes in the past 2 years; and the commonly used markers TnI and BNP respectively according to gender, age, month classification statistics, analysis of the changes of the positive results of 2 years of clinical application and application of SPSS 19.0 software. Results The clinical application of MYO for H-FABP, three indicators showed a downward trend; statistics of myocardial injury markers TnI positive seasonal variation trend,the winter season high(about 100 people), and reduce the summer(about 60 people); and there are significant gender differences,male hs-TNI(9.018±34.068) higher than that of ug/L female(P〈0.01); female patients have significant age differences, old patients with hs-TNI(8.87±32.11) μg/L high incidence in young patients(P〈0.01); cardiac function and markers of BNP in age and sex had no significant difference(P〉0.05). Conclusion The incidence of adverse cardiovascular events,is in female less than men,and is more common in winter.Recommend for attaching importance to the law and reasonably selecting cardiac markers,so as to early diagnosis and treatment.
出处
《世界复合医学》
2016年第2期14-18,共5页
World Journal of Complex Medicine