血清Hcy、Hs-CRP联合cTnⅠ检测在急性心肌梗死中的诊断及预后价值研究

The diagnostic and prognostic value of serum Hcy,Hs-CRP and cTnⅠ detection in acute myocardial infarction

目的探讨血清同型半胱氨酸(Hcy)、超敏C反应蛋白(Hs-CRP)联合心肌肌钙蛋白(cTnⅠ)检测在急性心肌梗死中的诊断及预后价值。方法选取2015年7月至2017年9月郑州市第七人民医院收治的61例急性心肌梗死患者作为观察组,另取60例同期健康体检者作为对照组,均行血清Hcy、Hs-CRP、cTnⅠ水平检测。观察两组血清Hcy、Hs-CRP、cTnⅠ水平,并分析其与预后相关性。结果观察组血清Hcy、Hs-CRP、cTnⅠ水平均高于对照组,差异有统计学意义(P<0.05)。血清Hs-CRP、Hcy、cTnⅠ联合检测诊断准确率为89.26%(108/121)、敏感度为95.08%(58/61),均高于各指标单一检测,差异有统计学意义(P<0.05)。预后优良组血清Hcy、Hs-CRP、cTnⅠ水平低于预后一般组,差异有统计学意义(P<0.05)。血清Hcy、Hs-CRP、cTnⅠ水平与预后呈负相关(P<0.05)。结论急性心肌梗死患者血清Hcy、Hs-CRP、cTnⅠ水平较健康者高,其水平高者预后较差,可作为诊断和评估预后的有效指标。

Objective To investigate the value of serum homocysteine（ Hcy）,hypersensitive C-reactive protein（ Hs-CRP） and cTnⅠ in the diagnosis and prognosis of acute myocardial infarction. Methods Sixty-one patients with acute myocardial infarction who were admitted to the Seventh People＇s Hospital of Zhengzhou from July of 2015 to September of 2017 were selected as the observation group. Another 60 healthy patients were taken as the control group. Levels of serum Hcy,Hs-CRP and cTnⅠ were all measured and observed in two groups. Results The levels of Hcy,Hs-CRP and cTnⅠ in the observation group were higher than those in the control group（ P〈0. 05）. The diagnostic accuracy of combined detection of serum Hs-CRP,Hcy,and cTnⅠ was 89. 26%（ 108/121） and the sensitivity was 95. 08%（ 58/61）,which were higher than those if the single detection of each index,and the difference was statistically significant（ P〈0. 05）. The levels of Hcy,Hs-CRP,and cTnⅠ in the patients with good prognosis were lower than those in the general group,and the difference was statistically significant（ P〈0. 05）. Serum levels of Hcy,Hs-CRP and cTnⅠ were negatively correlated with prognosis（ P〈0. 05）. Conclusion Serum levels of Hcy,Hs-CRP and cTnⅠ in patients with acute myocardial infarction are higher than those in healthy individuals.The higher the level,the worse the prognosis.