可溶性血管内皮生长因子受体1在急性心肌梗死早期诊断中的价值

Value of soluble vascular endothelial growth factor receptors 1 in early diagnosis of acute myocardial infarction

目的探讨可溶性血管内皮生长因子受体1(sFlt-1)在急性心肌梗死(AMI)早期诊断中的价值。方法选取235例在胸痛发病12h内就诊,最终诊断为AMI患者168例(A组)、不稳定型心绞痛患者35例(B组)和非缺血性胸痛患者32例(C组)。入院后10min内(T1)、2h(T2)、4h(T3)和8h(T4)时分别抽取静脉血,以ELISA法检测血浆sFlt-1水平,免疫荧光法检测心肌肌钙蛋白I(cTnI)水平。结果 T1时,A组血浆sFlt-1水平高于B组和C组(P<0.05);T2时,A组血浆sFlt-1与B组无统计学差异(P>0.05),但高于C组(P<0.05);T3、T4时,三组血浆sFlt-1水平相仿(P>0.05)。T1时,A组血浆cTnI高于B组和C组(P<0.01)。T1时采用sFlt-1与cTnI联合诊断AMI的AUC[0.962,95%CI(0.930~0.983)]高于sFlt-1和cTnI单独诊断AMI的AUC[0.825,95%CI(0.770~0.871)和0.867,95%CI(0.817~0.908)](P<0.01)。结论在AMI发生早期检测sFlt-1,有助于提高AMI的早期诊断。

Objective To explore the value of soluble vascular endothelial growth factor receptors 1（sFlt-1）in the early diagnosis of acute myocardial infarction（AMI）.Methods A total of 235 patients admitted to hospital in 12 hours after chest pain occurred was diagnosed as AMI（group A,168 cases）,unstable angina（group B,35 cases）and non-ischemic chest pain（group C,32 cases）.The venous blood was collected within 10 min（T1）,at 2 hours（T2）,4 hours（T3）and 8 hours（T4）after admission.Plasma sFlt-1 was measured by ELISA and calpain I（cTnI）by immunofluorescence.Results Plasma level of sFlt-1 at T1 was higher in group A than that in groups of B and C（P〈0.05）,which at T2 was higher in groups of A than that in group C（P〈0.05）but was not significantly different between group of A and B（P〉0.05）.Plasma levels of sFlt-1 at T3 and T4 were not significantly different among three groups（P〉0.05）.Plasma level of cTnI at T1 was higher in group A than that in groups of B and C（P〈0.01）.The AUC of combined detection of sFlt-1 and cTnI at T1 in the diagnosis of AMI was more than that of detecting sFlt-1 or cTnI alone[0.962,95%CI（0.930~0.983）vs.0.825,95%CI（0.770~0.871）and 0.867,95%CI（0.817~0.908）]（P〈0.01）.Conclusion Early detection of sFlt-1 can help to improve the early diagnosis of AMI.