同型半胱氨酸与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研究

Study on combined detection of Hcy and RDW CV in the diagnosis of acute myocardial infarction

目的研究同型半胱氨酸(Hcy)与红细胞体积分布宽度变异系数(RDW CV)联合检测在急性心肌梗死诊断中的应用价值。方法回顾分析2016年1月—2017年10月我院心内科收治的急性心肌梗死、心绞痛及体检正常者的相关资料,将其中30例急性心肌梗死患者作为观察组,心绞痛患者30例作为心绞痛对照组,同期体检正常者30例作为正常对照组,对3组Hcy与RDW CV水平进行测定,分析两指标单独及联合检测的诊断效能。结果观察组患者Hcy、RDW CV水平均显著高于心绞痛对照组和正常对照组,差异具有统计学意义(P<0.05);观察组联合检测阳性率显著大于Hcy、RDW CV单独检测阳性率,联合检测敏感性、阴性预测值、预测准确值均显著大于单独检测结果,差异具有统计学意义(P<0.05)。结论 Hcy与RDW CV联合检测在急性心肌梗死诊断中具有较高的敏感性和准确度,可显著提高临床诊断准确率。

Objective To study the application value of combined detection of homocysteine （Hcy） and red blood cell volume distribution width coefficient of variation （RDW CV） in the diagnosis of acute myocardial infarction （AMI）.Methods The clinical data of AMI, angina pectoris and healthy controls in the department of clinical laboratory from January 2016 to October 2017 were retrospectively analyzed. 30 cases of AMI were selected as observation group, 30 cases of angina pectoris were selected as angina pectoris control group, and 30 cases of healthy controls were selected as normal control group. The levels of Hcy and RDW CV of three groups were assessed. The positive rate, sensitivity, specificity, positive predictive value, negative predictive value, accuracy rate of single detection and corhbined detection of Hcy and RDW CV were analyzed. Results The levels of Hcy and RDW CV in observation group were higher than those in angina pectoris control group and normal control group （P〈0.05）; The positive rate of combined detection in observation group was higher than that of single detection of Hcy or RDW CV, the sensitivity, specificity, positive predictive value, predictive accuracy of combined detection were higher than those of single detection of Hcy or RDW CV, the negative predictive value of combined detection was higher than those of single detection of Hcy or RDW CV （P〈0.05）. Conclusion Combined detection of Hcy and RDW CV in the diagnosis of AMI has higher sensitivity and specificity, which can significantly increase the clinical diagnostic accuracy.