同型半胱氨酸和红细胞体积分布宽度变异系数联合检测对急性心肌梗死的诊断价值

Diagnosis Value of Homocysteine and Red Blood Cell Volume Distribution Width Coefficient of Variation for Acute Myocardial Infarction

目的:探讨同型半胱氨酸(Hcy)和红细胞体积分布宽度变异系数(RDW CV)联合检测对急性心肌梗死(AMI)的诊断价值。方法:收集我院2012年1月到2013年6月冠心病患者300例,其中心绞痛121例、缺血性心力衰竭65例、AMI例114例。同期收集我院体检正常者100例为对照组,利用全自动细胞分析仪和免疫法分别测定Hcy和RDW CV,分析二者联合对AMI诊断价值。结果:Hcy与RDW CV水平在四组的差别具有统计学意义(P<0.05),其中AMI组中Hcy与RDW CV水平明显高于其他三组水平,差异具有统计学意义(P<0.05);Hcy、RDW CV以及二者联合诊断AMI组阳性率之间差别具有统计学意义(P<0.05),对对照组的检测阳性率差异无统计学意义(P>0.05);Hcy单独检测灵敏度和特异度分别为68.42%、86.00%,RDW CV单独检测灵敏度和特异度分别为64.91%、84.00%,联合检测灵敏度和特异度分别为83.33%、93.00%,差异具有统计学意义(P<0.05),联合检测的一致率、阳性预测值、阴性预测值分别为87.85%、93.14%、83.04%。结论:Hcy联合RDW CV诊断AMI具有相对较高的灵敏度、特异度、一致率、阳性预测值和阴性预测值。

Objective： To investigate the diagnosis value of homocysteine （Hcy） and red blood cell volume distribution width coefficient of variation （RDW-CV）for acute myocardial infarction （AMI）. Methods： 300 patients with coronary heart disease were collected in our hospital from January 2012 to June 2013,including 121 cases of angina, 65 cases ofischemic heart failure, 114 cases of AMI, and 100 cases of health people were collected over the same period, as control group, Hey and RDW-CV in two groups were measured by automatic cell analyzer and immunoassay method, and analyzed the diagnostic value of above two indexes combination for AMI. Results： The levels of Hey and RDW-CV in the four groups were statistically different （P〈0.05）, which in AMI group was significantly higher than the other three groups, the differences were statistically significant（P〈0.05）; The positive rates of Hey, RDW-CV and Hey combined with RDW-CV on diagnosing AMI were statistically different （P〈0.05）, but they showed no significant difference in the control group （P〉0.05）; The sensitivity and specificity of Hey were 68.42%, 86.00%, which of RDW-CV were 64.91%, 84.00%, combined detection sensitivity and specificity were 83.33%, 93.00%, the difference was statistically significant （P〈0.05）, consistent rate, positive predictive value, and negative predictive value of combined detection were 87.85%, 93.14%, 83.04%. Conclusion： Hey combined with RDW-CV has relatively higher sensitivity, specificity, consistent rate, positive predictive value and negative predictive value on diagnosis AMI.