急诊超声心动图联合血清NT-proBNP、cTnI、CK-MB诊断急性心肌梗死的临床价值分析

Clinical Value Analysis of Emergency Echocardiography Combined with Serum NT-proBNP, cTnI and CK-MB in the Diagnosis of Acute Myocardial Infarction

目的:研究急诊超声心动图联合血清氨基末端脑钠肽前体(NT-proBNP)、肌钙蛋白(cTnI)和肌酸激酶同工酶(CK-MB)诊断急性心肌梗死(AMI)的临床价值。方法:将2019年12月至2020年6月期间我院收治的82例AMI患者纳入研究,记作病变组。另取同期于我院进行体检的健康者80例作为对照组。比较两组各项超声心动图指标水平,血清NT-proBNP、cTnI和CK-MB水平。分析超声心动图指标与血清NT-proBNP、cTnI和CK-MB的相关性。以受试者工作特征(ROC)曲线分析超声心动图联合血清NT-pro BNP、cTnI和CK-MB水平诊断AMI的效能。结果:病变组左心室射血分数(LVEF)低于对照组,而左室舒张末期内径(LVEDD)高于对照组(P<0.05)。病变组血清NT-proBNP、cTnI和CK-MB水平均高于对照组(P<0.05)。Pearson检验显示LVEF与血清NT-proBNP、cTnI和CK-MB均呈负相关(r=-0.514、-0.578、-0.532,均P<0.05),LVEDD与血清NT-proBNP、cTnI和CK-MB均呈正相关(r=0.625、0.594、0.575,均P<0.05)。超声心动图联合血清三项诊断AMI的曲线下面积、灵敏度以及特异度均高于超声心动图、血清三项单独诊断。结论:超声心动图联合血清NT-proBNP、cTnI和CK-MB诊断AMI的价值较高,具有一定的临床应用价值。

Objective: To study the clinical value of emergency echocardiography combined with serum n-terminal brain natropeptide precursor(NT-proBNP), troponin(cTnI) and creatine kinase isoenzyme(CK-MB) in the diagnosis of acute myocardial infarction(AMI). Methods: 82 patients with AMI admitted to our hospital from December 2019 to June 2020 were included in the study,which were labeled as the lesion group. In addition, 80 healthy physical examinees in our hospital during the same period were selected as control group. The levels of echocardiography indexes, serum NT-proBNP, cTnI and CK-MB were compared between the two groups.The correlation between echocardiography and serum NT-proBNP, cTnI and CK-MB was analyzed. Receiver operating characteristic(ROC) curve was used to analyze the diagnostic efficacy of echocardiography combined with levels of serum NT-proBNP, cTnI and CK-MB in diagnosing AMI. Results: The left ventricular ejection fraction(LVEF) of the lesion group was lower than that of the control group, while the left ventricular end diastolic diameter(LVEDD) was higher than that of the control group(P<0.05). The levels of serum NT-pro BNP, cTnI and CK-MB of the lesion group were all higher than those of the control group(P<0.05). Pearson test showed that LVEF was negatively correlated with serum NT-proBNP, cTnI and CK-MB(r=-0.514,-0.578,-0.532;all P <0.05);LVEDD was positively correlated with serum NT-proBNP, cTnI and CK-MB(r=0.625, 0.594, 0.575;all P<0.05). The area under curve, sensitivity and specificity of echocardiography combined with serum three items in diagnosing AMI were all higher than those of the echocardiography and serum three items separate diagnosing. Conclusion: The value of echocardiography combined with serum NT-proBNP, cTnI and CK-MB in the diagnosis of AMI is relatively high, which has certain clinical application value.