多指标联合检测在急性心肌梗塞诊断中的应用

Application of combined detection of multiple indicators in the diagnosis of acute myocardial infarction

目的探讨微小核糖核酸RNA-208a( miR-208a)、肌酸激酶同工酶( CK-MB)和肌钙蛋白I( cTnI)联合检测在急性心肌梗塞( AMI)诊断中的价值。方法选择 2017年11月-2018年10月在台州市第一人民医院住院的46例AMI患者和同期来院健康体检的35例对照者为研究对象,分离外周静脉血清,检测CK-MB和cTnI,采用实时荧光定;量PCR检测miR -208a。结果miR-208a在3 h、6h、12 h表达显著高于对照组(P<0.05);CK-MB和cTnI在6 h、12 h、24 h表达显著高于对照组(P<0.05)。miR-208a、CK-MB和cTnI在单独AMI诊断中的敏感度和曲线下面积(ROC)均较低,三项指标联合检测的敏感度和ROC均有较大提高。结论miR-208a、CK-MB和cTnI在AMI发生后不同时间段表达变化对AMI的诊断和治疗有重要价值,联合检测能提高诊断效能。

Objective To investigate the value of combined detection of microRNA-208a ( miR- 208a), creatine kinase isoenzyme (CK- MB) and troponin I (cTnI) in the diagnosis of acute myocardial infarction ( AMI). Methods Forty-six patients with AMI who were admitted to the First People’s Hospital of Taizhou from November 2017 to October 2018 and 35 controls for physical examination at the same time were selected. Peripheral venous serum was isolated and tested for CK-MB and cTnI. Real-time quantitative PCR was used to detect miR-208a. Results The expression of miR-208a was significantly higher at3 h, 6 h and 12 h than that of the control group (P <0.05), the expressions of CK-MB and cTnI were significantly higher at6h, 12 h and 24 h than that of the control group (P <0.05). The sensitivity and ROC of miR-208a, CK-MB and cTnI were lower in the diagnosis of AMI alone, and the sensitivity and ROC of the combined detection of three indicators were improved. Conclusion The expression changes of miR-208a, CK- MB and cTnI at different time points after AMI are valuable for the diagnosis and treatment of AMI. Combined detection can improve the diagnostic efficiency.