三种血清标志物联合检测在冠心病诊断中的临床价值

Clinical value of combined measurement of serum NT-proBNP,MCP-1 and FKN levels in diagnosis of CHD

目的探讨血清N末端B型钠尿肽前体(NT-proBNP)、单核细胞趋化蛋白1(MCP-1)和不规则趋化因子(FKN)联合检测在冠心病诊断中的临床价值。方法选择2016年3月~2018年3月东方市人民医院心血管内科收治的冠心病患者118例,根据临床诊断分为稳定性心绞痛(SAP)患者42例(SAP组),不稳定性心绞痛(UAP)患者30例(UAP组),急性心肌梗死(AMI)患者46例(AMI)组。同期收集我院健康体检者54例(对照组)。采用ELISA法检测各组血清NT-proBNP、MCP-1和FKN水平,并且评价各指标单独检测与联合检测对冠心病患者的临床诊断价值。结果与对照组比较,SAP组、UAP组和AMI组血清NT-proBNP、MCP-1和FKN水平明显升高,差异有统计学意义(P<0.05)。与SAP组比较,UAP组和AMI组血清NT-proBNP、MCP-1和FKN水平明显升高,差异有统计学意义(P<0.05)。与UAP组比较,AMI组血清NT-proBNP、MCP-1和FKN水平明显升高,差异有统计学意义(P<0.05)。3种血清标志物联合检测诊断冠心病的敏感性和准确率明显高于分别单独检测血清NT-proBNP、MCP-1和FKN,差异有统计学意义(90.68%vs 77.97%、75.42%、76.27%,P=0.010;91.28%vs 79.07%、77.91%、76.74%,P=0.001)。结论冠心病患者血清NT-proBNP、MCP-1和FKN水平可反映冠心病的严重程度,三者联合检测可提高冠心病诊断。

Objective To study the clinical value of combined measurement of serum NT-proBNP,MCP-1 and FKN levels in diagnosis of CHD.Methods One hundred and eighteen CHD patients admitted to our hospital from March 2016 to March 2018 were divided into stable angina pectoris(SAP)group(n=42),unstable angina pectoris(UAP)group(n=30),acute myocardial infarction(AMI)group(n=46)with 54 healthy volunteers who underwent physical examination in our hospital served as a control group.Their serum NT-proBNP,MCP-1 and FKN levels were measured by ELISA.The clinical value of combined measurement of serum NT-proBNP,MCP-1 and FKN levels or measurement of them respectively in diagnosis of CHD was assessed.Results The serum NT-proBNP,MCP-1 and FKN levels were significantly higher in SAP group,UAP group and AMI group than in control group(P<0.05),in UAP group and AMI group than in SAP group(P<0.05),and in AMI group than in UAP group(P<0.05).The sensitivity and accuracy of combined measurement of serum NT-proBNP and MCP-1 and FKN levels were significantly higher than those of measurement of them respectively(90.68% vs 77.97%,75.42%,76.27%,P=0.010;91.28% vs 79.07%,77.91%,76.74%,P=0.001).Conclusion Serum NT-proBNP,MCP-1 and FKN levels can indicate the severity of CHD.Combined measurement of them can improve the diagnosis of CHD.