降钙素原、乳酸对急性心肌梗死合并心源性休克患者的临床诊断价值

Diagnostic value of procalcitonin and lactic acid in patients with acute myocardial infarction complicated with cardiogenic shock

目的探讨降钙素原(procalcitonin,PCT)、乳酸(lactic acid,LAC)对急性心肌梗死(acute myocardial infarction,AMI)合并心源性休克(cardiogenic shock,CS)患者的临床诊断价值。方法选取2013年1月—2016年3月安徽医科大学附属安庆医院心内科确诊为AMI的患者234例,分为合并CS组(21例)和未合并CS组(213例),比较2组间基线资料以及PCT、LAC等指标,绘制受试者工作特征曲线(ROC),评价PCT、LAC对AMI合并CS患者临床诊断价值。结果 234例AMI患者中,合并CS组对比未合并CS组PCT[(0.26±0.30)ng/ml vs(0.09±0.16)ng/ml,P<0.01]、LAC[(5.78±2.12)mmol/L vs(1.77±1.09)mmol/L,P<0.01]。PCT、LAC评价AMI是否合并CS的ROC曲线分析显示,PCT曲线下面积(AUC):0.826,95%CI:0.746~0.905(P<0.05),灵敏度:81.0%,特异度:76.5%;LAC曲线下面积(AUC):0.877,95%CI:0.807~0.953(P<0.05),灵敏度:83.5%,特异度:81.2%。结论 PCT、LAC预测AMI合并CS具有一定诊断价值。

Objective To investigate the clinical diagnostic value ofprocalcitonin （PCT） , and lactic acid （LAC） in patients with acute myocardial infarction （AMI） complicated with cardiogenic shock（CS）. Methods A total of 234 patients with AMI treated in the Department of Cardiology between January 2013 and March 2016 were prospectively studied. Patients were divided into the CS group （n=21） and non-CS group （n=213）. Levels of PCT and LAC and baseline data were compared between the two groups. The receiver operating characteristic （ROC） curve was plotted to assess the clinical diagnostic value of PCT and LAC in patients with AMI complicated with CS. Results In all the patients, the levels of PCT [ （0.26±0.03） ng/ml vs （0.09±0.02） ng/ml, P〈0.01] and LAC[ （5.78±2.12） mmol/L vs （1.77±1.09） mmol/L, P〈0.01] in CS group were significantly higher than those in non-CS group. The ROC curve suggested that AUC was 0.826, 95%CI was 0.746-0.905, P〈0.05, sensitivity was 81.0%, and specificity was 76.5% for PCT, compared to 0.877, 95%CIwas 0.807-0.953, P〈0.05, 83.5%, and 81.2% for LAC. Conclusion The levels of PCT and LAC are of clinical value for patients with AMI complicated with CS.